Abstract
In this paper, we develop and solve a model for the location and allocation of specialized health care services such as traumatic brain injury (TBI) treatment. The model is based on and applied to one of the Department of Veterans Affairs’ integrated service networks. A cost minimization model with service proportion requirements is solved using simulated annealing. Large instances of the model with 100 candidate medical center locations and 15 open treatment units are solved in about 1000 s. In order to test the real-world applicability of our model, an extensive managerial experiment is conducted using data derived from our health care setting. In this experiment, the effects of three critical factors: (1) degree of centralization of services, (2) the role of patient retention as a function of distance to a treatment unit, and (3) the geographic density of the patient population are investigated with respect to the important trade-off between the cost of providing service and the need to provide such service. Our analysis shows that all three factors of the experiment are both relevant and useful to decision-makers when selecting locations for their services.
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