NDLI: Can we optimize locations of hospitals by minimizing the number of patients at risk?

Content Provider	Springer Nature : BioMed Central
Author	Fränti, Pasi Mariescu-Istodor, Radu Akram, Awais Satokangas, Markku Reissell, Eeva
Abstract	Background To reduce risk of death in acute ST-segment elevation myocardial infraction (STEMI), patients must reach a percutaneous coronary intervention (PCI) within 120 min from the start of symptoms. Current hospital locations represent choices made long since and may not provide the best possibilities for optimal care of STEMI patients. Open questions are: (1) how the hospital locations could be better optimized to reduce the number of patients residing over 90 min from PCI capable hospitals, and (2) how this would affect other factors like average travel time. Methods We formulated the research question as a facility optimization problem, which was solved by clustering method using road network and efficient travel time estimation based on overhead graph. The method was implemented as an interactive web tool and tested using nationwide health care register data collected during 2015–2018 in Finland. Results The results show that the number of patients at risk for not receiving optimal care could theoretically be reduced significantly from 5 to 1%. However, this would be achieved at the cost of increasing average travel time from 35 to 49 min. By minimizing average travel time, the clustering would result in better locations leading to a slight decrease in travel time (34 min) with only 3% patients at risk. Conclusions The results showed that minimizing the number of patients at risk alone can significantly improve this single factor but, at the same time, increase the average burden of others. A more appropriate optimization should consider more factors. We also note that the hospitals serve also for other operators than STEMI patients. Although optimization of the entire health care system is a very complex optimization problems goal, it should be the aim of future research.
Related Links	https://bmchealthservres.biomedcentral.com/counter/pdf/10.1186/s12913-023-09375-x.pdf
Ending Page	15
Page Count	15
Starting Page	1
File Format	HTM / HTML
ISSN	14726963
DOI	10.1186/s12913-023-09375-x
Journal	BMC Health Services Research
Issue Number	1
Volume Number	23
Language	English
Publisher	BioMed Central
Publisher Date	2023-04-29
Access Restriction	Open
Subject Keyword	Public Health Health Administration Health Informatics Nursing Research Health care information systems Facility optimization Clustering Myocardial infarction
Content Type	Text
Resource Type	Article
Subject	Health Policy

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
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4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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