Location Of Health Facilities Research Articles

A stochastic optimization model for patient evacuation from health care facilities during hurricanes

We propose a rigorous modeling and methodological effort that integrates statistical implementation of hydrology models in predicting inland and coastal flood scenarios due to hurricanes and a scenario-based stochastic integer programming model which suggests resource and staging area decisions in the first stage and the evacuation decisions in the second stage. This novel study combines physics-based flood prediction models and stochastic optimization for large-scale multi-facility coordination of hospital and nursing home evacuations before impending hurricanes. The optimization model considers scenario-dependent evacuation demand, transport vehicles with varying capacities, and both critical and non-critical patients. Utilizing Hurricane Harvey of 2017 as a case study and actual healthcare facility locations in southeast Texas, we explore various evacuation policies, demonstrating the impact of routing strategies, staging area decisions, flood thresholds, and receiving facility capacities on evacuation outcomes. One of the findings is that choosing staging area(s) and deploying evacuation vehicles optimally considering the uncertainty of the hurricane’s path at the time of decision making could have significant effect on the total cost of the operation and evacuation time experienced by the evacuees. We also show the non-negligible value of the scenario-based staging and routing solution conservatively calculated in relation to a single scenario solution using the concept of value of stochastic solution.

Evaluating health workers attitude towards implementation of maternal and perinatal deaths surveillance and response system in Morogoro region; analytical cross-sectional study.

Maternal and Perinatal Deaths Review and Surveillance (MPDSR) is a technical system which was issued by the World Health Organization in 2013 to help developing countries improve maternal health. The major purpose of the system was to reduce the ongoing high numbers of maternal deaths and perinatal deaths from avertable causes. Tanzania adopted MPDSR system in 2015. The study aimed to assess health workers attitude towards implementation of MPDSR system in Morogoro Region. This analytical cross-sectional study was conducted in three districts of Morogoro region from April 27, 2020 to May 29, 2020 involving 360 health workers from 38 health facilities. A semi-structured questionnaire was used for data collection. SPSS software version 25 was used to analyze the obtained data. Descriptive analysis was done to describe the characteristics of study participants. Binary logistic regression analysis was used to assess predictors of health workers attitude towards the MPDSR system. A total of 255(70.8%) of respondents had positive attitude towards MPDSR system. After controlling of confounders predictor of positive attitude were location of health facility [rural (AOR = 0.216 at 95% CI = 0.121-0.387, p = <0.001)], Age group [Below 30(AOR = 0.459 at 95%CI = 0.264-0.796, p = 0.006)] and status of training on MPDSR [Yes (AOR = 4.892 at 95%CI = 2.187-10.942, P = <0.001)]. Substantial number of health workers had positive attitude towards the MPDSR system. Health workers who were residing in rural settings and younger than 30 years were less likely to have positive attitude towards the system. Health workers who had access to be trained about the system were more likely to have positive attitude towards MPDSR system. The study recommends the training of health workers about the system so as to increase their attitude and hence the use of the system.

Correction to: Preventive healthcare facility location planning with quality-conscious clients

Correction to: Preventive healthcare facility location planning with quality-conscious clients

Impact of comorbid opioid use disorder and major depressive disorder on healthcare utilization outcomes in patients with peripheral artery disease: A National Readmission Database analysis.

Prior research has demonstrated that individuals with peripheral artery disease (PAD) often have comorbid opioid use disorder (OUD) and major depressive disorder (MDD), with limited data regarding their impact on readmission outcomes, length of stay, and cost. This study aimed to investigate these healthcare utilization outcomes in patients with PAD who have comorbid OUD and MDD. Data were obtained from the National Readmission Database from 2011 through 2018. The study population included all hospitalizations with PAD as the primary or secondary diagnosis, from which hospitalizations with OUD and MDD were extracted using appropriate ICD-9/10 diagnosis codes. Primary outcomes were 30-day and 90-day readmission, total cost, and total length of stay within the calendar year. We created hierarchical multivariable logistic regression models examining OUD with and without MDD, with a random effect for healthcare facility location. From 2011 to 2018, 13,265,817 weighted admissions with PAD were identified. These admissions were segmented into four categories: No OUD/No MDD (12,056,466), OUD/No MDD (323,762), No OUD/MDD (867,641), and OUD/MDD (17,948). The group with No OUD/No MDD was used as the reference group for all subsequent comparisons. Regarding 30-day and 90-day readmissions, patients with OUD/MDD had odds of 1.14 (95% CI 1.10, 1.18) and 1.09 (95% CI 1.06, 1.13), respectively. Patients with OUD/No MDD bore the highest median cost of $64,354 (IQR $30,797-137,074), and patients with OUD/MDD marked the lengthiest median stay of 6.01 days (IQR 2.01-13.30). This study found a significant association between these comorbidities and outcomes and therefore calls for targeted interventions and pain management strategies.

Environmental Quality Analysis of Settlement Around the Electric Steam Power Plant (PLTU) Palabuhanratu, Sukabumi, West Java

According to the Central Statistics Agency, Indonesia's population growth rate will reach 1.17% in 2022 and will continue to increase exponentially annually. Moreover, the increasing number of population growth leads to several issues, including environmental quality of settlement. This study examined the quality of the environmental settlement around the Electric Steam Power Plant (PLTU) Palabuhanratu. The data used in this study is a combination of open-source data and field survey data. The method used is an interpretation technique (satellite imagery) assisted by geographic information system (GIS) technology with six-parameters, there are settlement density, settlement layout, settlement location, road conditions, building conditions and availability of health facilities. The results of this study are information including settlement quality and recommendations related to the quality of the environmental settlement around the PLTU Palabuhanratu which can be used as input in spatial planning in the Palabuhanratu area for sustainable regional development. Overall, this research shows that the environmental quality of settlements around PLTU Palabuhanratu is dominated by good category. However, it is possible that the quality of settlements will deteriorate in the future because the percentage of population density which almost close to 40%.

Assessment of criteria influencing the location of healthcare facilities in small and hard-to-reach areas

Aim. To identify and systematize the criteria influencing the location of healthcare facilities in small and hard-to-reach areas.Material and methods. Within the study, regulatory legal acts of the Russian Federation and methodological guidelines on territorial planning were analyzed. Content analysis and statistical methods were used.Results. The following criteria for a comprehensive assessment of the location of healthcare facilities should be used: 1. Age structure of the population. 2. Distance to a similar medical organization. 3. Population size within the working radius of the organization. 4. Availability of public roads (criteria and categories of roads). 5. Availability of public transport. 6. Climatic. 7. Availability of medical workers residing in the locality. 8. Availability of mobile medical teams. 9. Dilapidation and breakdown of buildings. Taking into account various criteria affecting the accessibility of primary health care to a patient, it is possible to develop and implement management decisions on the rational placement of healthcare facilities at the regional level with detail for each locality.Conclusion. The use of criteria in territorial planning for a comprehensive assessment of the location of healthcare facilities makes it possible to take into account regional climatic, geographic, infrastructural, social and other features of the Russian constituent entities. This contributes to the implementation of development targets for primary health care in small and hard-to-reach areas.

Reported antibiotic use among patients in the multicenter ANDEMIA infectious diseases surveillance study in sub-saharan Africa

BackgroundExposure to antibiotics has been shown to be one of the drivers of antimicrobial resistance (AMR) and is critical to address when planning and implementing strategies for combatting AMR. However, data on antibiotic use in sub-Saharan Africa are still limited. Using hospital-based surveillance data from the African Network for Improved Diagnostics, Epidemiology and Management of Common Infectious Agents (ANDEMIA), we assessed self-reported antibiotic use in multiple sub-Saharan African countries.MethodsANDEMIA included 12 urban and rural health facilities in Côte d’Ivoire, Burkina Faso, Democratic Republic of the Congo, and Republic of South Africa. Patients with acute respiratory infection (RTI), acute gastrointestinal infection (GI) and acute febrile disease of unknown cause (AFDUC) were routinely enrolled, and clinical, demographic, socio-economic and behavioral data were collected using standardized questionnaires. An analysis of ANDEMIA data from February 2018 to May 2022 was conducted. Reported antibiotic use in the ten days prior to study enrolment were described by substance and by the WHO AWaRe classification (“Access”, “Watch”, “Reserve”, and “Not recommended” antibiotics). Frequency of antibiotic use was stratified by location, disease syndrome and individual patient factors.ResultsAmong 19,700 ANDEMIA patients, 7,258 (36.8%) reported antibiotic use. A total of 9,695 antibiotics were reported, including 54.7% (n = 5,299) from the WHO Access antibiotic group and 44.7% (n = 4,330) from the WHO Watch antibiotic group. The Watch antibiotic ceftriaxone was the most commonly reported antibiotic (n = 3,071, 31.7%). Watch antibiotic use ranged from 17.4% (56/322) among RTI patients in Côte d’Ivoire urban facilities to 73.7% (630/855) among AFDUC patients in Burkina Faso urban facilities. Reported antibiotic use included WHO Not recommended antibiotics but no Reserve antibiotics.ConclusionsReported antibiotic use data from this multicenter study in sub-Saharan Africa revealed a high proportion of WHO Watch antibiotics. Differences in Watch antibiotic use were found by disease syndrome, country and health facility location, which calls for a more differentiated approach to antibiotic use interventions including further evaluation of accessibility and affordability of patient treatment.

Examining factors driving inequities in water, sanitation, hygiene, and waste management services in healthcare facilities in Ghana: An analysis of routine national data

Abstract In Ghana, little is known about the drivers of inequities of basic water, sanitation, and hygiene (WASH) services in healthcare facilities (HCFs). We aim to examine the status and factors driving access to basic WASH services in Ghana. This survey involved an analysis of routine health service data submitted to the District Information Management System 2 (DHIMS 2). Complete data were available for 1,646 HCFs across Ghana for analysis. Coverage of basic Water, Sanitation and hygiene services was 69, 58, and 64%, respectively. About 50% had a WASH-IPC action plan, and 67% had a WASH-IPC manager who is responsible for the day-to-day WASH management. Regional inequities in access to basic WASH services exist, with the newly established regions and those in Northern Ghana being disadvantaged. Significant drivers of basic WASH services were the location of HCF, the level of service delivery, and availability of a trained facility-based assistant WASH manager. WASH services in Ghanaian HCFs have improved, but it is still not up to the standards set by the Sustainable Development Goals for WASH. Universal access to basic WASH services can be attained by mounting targeted WASH interventions and appointing WASH-IPC managers at all levels of the health system.

Estimating Demand for Healthcare Facilities in Rural Developing Countries

Spatial analysis provides decision support for numerous public health issues such as determining locations of healthcare facilities for a given population. With limited population health data available for developing countries, spatial data analysis provides limited benefit in this regard. This paper attempts to assist public health practitioners in overcoming the health information gaps common to developing countries for determining health-related demand locations. We introduce methodologies that use generally available information from Demographic and Health Surveys (DHS). Burkina Faso, a developing country with poor health quality, is used in this paper as a case study to show how DHS data, not generally used for spatial analysis, can be used to estimate multiple area demand locations for healthcare facilities. Factors used to locate demand per administrative province included population density, proximity to major road networks, economic wealth index, birth rate, childhood stunting, and malaria rates. Major health issues in populated areas along access routes ultimately determined the estimated area demand for healthcare facility locations in this analysis.

Home health care facility location problem under demand uncertainty

The demand for home health care services is rapidly increasing due to the growing number of older people. The uncertainty surrounding this demand affects the network design processes and the performance of the home health care system in the long term. This study aims to address the issue of demand uncertainty in a home health care location problem. While decisions regarding the location of home health care facilities must be made immediately, the determination of distribution can be postponed until actual demand is observed. In such situations, minimax/maximin robust optimization methods are commonly employed to address uncertainty and facilitate informed decision-making, even in cases where there is limited information about future demand. However, these methods are often too conservative and may lead to suboptimal solutions. To tackle this issue, we propose a regret minimization method, which is reformulated as a robust model to overcome its intractability. Additionally, we propose a column-and-constraint generation algorithm to solve the robust optimization and regret minimization models. Finally, we conduct a comprehensive set of numerical experiments to compare the performance of the models in terms of solution quality and computational time. The results demonstrate that the regret minimization model enhances solution quality and consumes less computational time when reformulated.

Abstract 262: Mediating Factors Between Community Race/Ethnicity and Initial Shockable Rhythm

Background: Initial shockable rhythm is an important predictor of favorable out-of-hospital cardiac arrest (OHCA) outcomes. While patients from minoritized communities suffer from lower rates of initial shockable rhythm, the reason for this disparity is not known. Hypothesis: OHCA characteristics contribute to disparities in initial shockable rhythm. Methods: We performed a retrospective study of the 2014-2021 Texas Cardiac Arrest Registry to Enhance Survival, including adult, non-traumatic OHCAs. Linked to census tract data, we stratified OHCAs based on having a majority of a race/ethnicity: &gt;50% White, &gt;50% Black, and &gt;50% Hispanic/Latino. To evaluate if initial shockable rhythm impacts outcome disparities, we compared logistic regression models between race and OHCA outcomes: 1) unadjusted, 2) adjusted for bystander CPR (bCPR), and 3) adjusted for initial rhythm. Using structural equation modeling, we then performed a mediation analysis between race/ethnicity, OHCA characteristics, and shockable rhythm, reporting the mediations proportions. Results: We included 39,596 OHCAs, 16,702 White, 5,461 Black, and 17,433 Hispanic. The rate of shockable rhythm was 19.0% for White, 14.3% for Black, and 14.6% for Hispanic. Odds of favorable neurologic outcome were lower for Black (OR 0.5, 95% CI 0.4-0.6) and Hispanic (OR 0.6, 95% CI 0.6-0.7). While adjusting for bCPR did not change these odds, adjusting for shockable rhythm increased odds for Black (OR 0.6, 95% CI 0.5-0.7) and Hispanic (OR 0.7, 95% CI 0.6-0.8). On mediation analysis, the proportion of initial shockable rhythm mediated for Black census tract were: age&gt;65 (-7.3%), male gender (6.8%), public location (6.9%), healthcare facility location (-17.2%), bystander witnessed (19.2%), bCPR (4.3%), and bystander AED (6.4%). The proportion mediated for Hispanic census tract were: age&gt;65 (-4.8%), male gender (0.5%), public location (-4.0%), healthcare location (-13.5%), bystander witnessed (20.8%), bCPR (8.7%), and bystander AED (6.2%). Conclusion: Bystander witnessed arrest was the most significant mediator of shockable rhythm for OHCA in Black and Hispanic communities, while bCPR was a modest mediator of shockable rhythm for Hispanic OHCA victims.

Searching For The Nearest Route To The Location Of Health Facilities Using The Djikstra Method

A health facility or health service facility is a tool or place used to carry out health service efforts, both in terms of promotive, preventive, curative and rehabilitative carried out by the central government, regional government or the community. This research contains development applications that cover every hospital, health center, and practice clinic located in the Langkat Regency area with the aim of facilitating the community in finding the nearest hospital, health center, and practice clinic. The application built can display the location of the health facility in map form and can display information in the form of name, address, telephone number, photo of the health facility, services available there, working hours, and further information on the place. In this study, the search for health facilities is only subject to distance as a health facility criterion, so that it can be developed further. To find the closest route to a health facility, here the author uses the Dijkstra Algorithm method which has been widely researched to be applied to the shortest route search system. This algorithm was invented by Edsger Dijkstra, a computer scientist from the Netherlands. The way Dijkstra's algorithm works is with a greedy strategy, namely at each step it chooses the side with the smallest value that connects the selected and unselected nodes/nodes. This algorithm requires a point of origin and a destination with the final result being the shortest distance from the point of origin to the destination along with the route.

Assessment of Availability of Tracer Drugs and Basic Diagnostics at Public Primary Health Care Facilities in Ethiopia During COVID-19 Pandemic.

The emergence of COVID-19 pandemic has disrupted the supply chain and stock of medicines and drugs across the globe. Tracer drugs are essential medicines that address the population's priority health problems. Thus, this study aimed to assess availability of tracer drugs and basic diagnostics at public primary health care facilities in Ethiopia. Facility based cross-sectional study was employed in four regions and one city administration. The primary health care units (PHCUs) were purposively selected in consultation with respective regional health bureaus. Finally, 16 hospitals, 92 health centers and 344 health posts were included. This study adopted WHO's tool that was being used to rapidly assess the capacity of health facilities to maintain the provision of essential health services during the COVID-19. Descriptive analysis was done using frequency and percentage, and results were presented. The overall mean availability of tracer drugs in PHCUs was 77.6%. Only 2.8% of PHCUs have all tracer drugs. The mean availability of basic diagnostic at national level was 86.6% in PHUs except health posts where it was less. Health facilities with all basic diagnostic services was 53.7%. Of the total 344 health posts assessed, 71% were providing diagnostic testing for malaria using either laboratory equipment or rapid diagnostic test (RDT) while 43% provide urine test for the pregnancy. This study shows availability of all tracer drugs in PHCUs in Ethiopia was extremely low. There was regional variation in availability of tracer drugs and basic diagnostics. It is very crucial to increase availability of tracer drugs and diagnostics. Drugs and diagnostic materials should be supplied according to the capacity and location of health facilities.

"For my safety and wellbeing, I always travel to seek health care in a distant facility"-the role of place and stigma in HIV testing decisions among GBMSM - BSGH 002.

Gays, bisexuals, and all other men who have sex with men (GBMSM) are heavily impacted by HIV in Ghana compared to the general population. In addition to HIV and same-sex intercourse stigma, barriers such as reduced privacy, lower-income status and limited health care facilities (HCF) affect HIV testing decisions among GBMSM. We employed a phenomenological research design to understand the role of place and stigma in HIV testing among GBMSM in slums. GBMSM (n=12) from slums in Accra and Kumasi, Ghana, were recruited and engaged in face-to-face interviews. We used a multiple reviewer summative content analysis to analyze and organize our key findings. The HIV testing options we identified include 1. Government HCF, 2. NGO and community outreach 3. Peer-educated services. Factors influencing GBMSM to test for HIV at HCF outside their areas included 1. The location of HCF 2. HIV and sexual stigma from slum areas 3. Positive HCW attitudes at distant HCF. 4. Negative Healthcare worker (HCW) attitudes towards GBMSM. These findings highlighted how stigma from slums and HCW influence HIV testing decisions and the need for place-based interventions to address stigma among HCW in slums to improve testing among GBMSM.

Racial and ethnic disparities in the provision of bystander CPR after witnessed out-of-hospital cardiac arrest in the United States

ObjectiveTo evaluate the association between race/ethnicity and the odds of receiving bystander cardiopulmonary resuscitation (bCPR) after witnessed out-of-hospital cardiac arrest (OHCA). MethodsFor this cross-sectional retrospective study, data were obtained from the National Emergency Medical Services Information System database for adults (≥18 years) with a witnessed non-traumatic OHCA in the year 2021. Patients were separated into two groups including Black/Hispanic and White. The primary outcome was the odds of receiving bCPR. We excluded traumatic etiology, do-not-resuscitate orders, and arrest in a healthcare facility or wilderness location. Multiple logistic regression controlling for known covariates was utilized and analyses were stratified by public versus non-public location, median household income, and rural, suburban, or urban setting. ResultsA total of 64,007 witnessed OHCAs were included. When compared to White, the Black/Hispanic group were younger (62 vs 67 years) and more often female (40% vs 33%), in neighborhoods with the lowest median household income (31% vs 13%) and in an urban setting (92% vs 80%). Overall, bystander CPR rates were 60% and 67% for the Black/Hispanic and White groups, respectively. Multiple logistic regression stratified by OHCA location found that the Black/Hispanic group had a decreased odds of receiving bCPR compared to the White group both in the home (adjusted OR [aOR] 0.77; 95% CI 0.74–0.81) and in public (aOR 0.69; 95% CI 0.64–0.76). This difference persisted throughout neighborhoods of different socioeconomic status and across the rural–urban spectrum. ConclusionsRacial/ethnic disparities exist for Black and Hispanic persons in the odds of receiving bCPR after a witnessed non-traumatic OHCA regardless of public or private setting, neighborhood income level, or population density.

RETRACTED ARTICLE: An optimization framework for the sustainable healthcare facility location problem using a hierarchical conflict resolution approach

RETRACTED ARTICLE: An optimization framework for the sustainable healthcare facility location problem using a hierarchical conflict resolution approach

Pemanfaatan WebGIS Pada Pemetaan Sebaran Layanan Kesehatan Kota Madiun

&#x0D; &#x0D; &#x0D; &#x0D; Kota madiun merupakan kota terbesar ke 4 setelah surabaya, malang dan kediri dengan berbagai sarana dan prasarana bagi masyarakat untuk mendukung kota sehat. Hingga saat ini fasilitas kesehatan yang tersebar di wilayah kota madiun sudah dikelompokkan berdasarkan kelurahan dan kecamatan. Namun sebaran fasilitas kesehatan di seluruh wilayah kota madiun belum dipetakan secara visualisasi mengenai tata letak lokasi fasilitas layanan kesehatan pada kondisi sesungguhnya. Dengan adanya visualisasi pemetaan sebaran lokasi fasilitas kesehatan, dapat dimanfaatkan sebagai referensi bagi para pengguna dalam mencari dan mengetahui lokasi fasilitas kesehatan. Dalam mengimplementasikan sistem pemetaan dikerjakan dengan menggunakan Sistem Informasi Geografis (SIG). Sistem dapat mengelola, memanipulasi, dan menggambarkan data berbasis spasial (keruangan) yang dapat dipergunakan di berbagai bidang, salah satunya dibidang kesehatan. SIG dapat dimanfaatkan untuk menilai ancaman serta sekaligus juga dapat dimanfaatkan untuk evaluasi dan pengawasan.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

Disruptions to in-person medical visits across the United States during the COVID-19 pandemic: evolving disparities by medical specialty and socio-economic status

ObjectivesThis study aimed to investigate how people's health-seeking behaviors evolve in the COVID-19 pandemic by community and medical service category. Study designThis is a longitudinal study using mobility data from 19 million mobile devices of visits to all types of health facility locations for all US states. MethodsWe examine the variations in weekly in-person medical visits across county, neighborhood, and specialty levels. Different regression models are used for each level to investigate factors that influence the disparities in medical visits. County-level analysis explores associations between county medical visit patterns, political orientation, and COVID-19 infection rate. Neighborhood-level analysis focuses on neighborhood socio-economic compositions as potential determinants of medical visit levels. Specialty-level analysis compares the evolution of visit disruptions in different specialties. ResultsA more left-leaning political orientation and a higher local infection rate were associated with larger decreases in in-person medical visits, and these associations became stronger, moving from the initial period of stay-at-home orders into the post-lockdown period. Initial reactions were strongest for seniors and those of high socio-economic status, but this reversed in post-lockdown period where socio-economically disadvantaged communities stabilized at a lower level of medical visits. Neighborhoods with more female and young people exhibited larger decreases in in-person medical visits throughout the initial and post-lockdown periods. The evolution of disruptions diverges across medical specialties, from only short-term disruption in specialties such as dentistry to increasing disruption, as in cardiology. ConclusionsGiven distinct patterns in visit between communities, medical service categories, and between different periods in the pandemic, policy makers, and providers should concentrate on monitoring patients in disrupted specialties who overlap with the at-risk contexts and socio-economic factors in future health emergencies.

A GIS-Based Spatial Decision Support System for Facility Location Planning in Nigeria

Abstract&#x0D; Public facilities are to be located optimally in the interest of society. In Nigeria, public facilities' locations are largely influenced by administrative constraints and politics, rather than efficiency and equity. This practice limits access, most especially, in rural communities where the population is dispersed. Studies on efficiency and equity in access to public health facilities focused on urban centres. The aim of this study, therefore, is to advance the understanding of the application of the spatial decision support system (SDSS) to evaluate efficiency and equity in access to public facilities in rural regions. The study used Ogun State, Nigeria as a case. The data used include the population and coordinates of the location of the settlements, coordinates of the location of health facilities and the transport networks. This study showed that 38.5% of settlements do not have access to primary care and the application of the p-median model showed that the efficiency of the existing location of health facilities can be improved by 40.6%. Application of the maximal covering location model showed that the existing maximum travel distance of 26.3km can be reduced. It can be reduced for the sake of equity to 9.9 km. This study demonstrated ways to develop evaluative tools for analyzing the distribution of public facilities in Nigeria. It is suggested that planners in rural regions of other developing countries can adopt these techniques and tools to make their location decisions more logical.&#x0D; Keywords: Geographic Information System, Public Health Facilities, Spatial Decision Support System, Location Efficiency, Location Equity.&#x0D;

A Two-Stage Optimization Approach for Healthcare Facility Location- Allocation Problems With Service Delivering Based on Genetic Algorithm.

Objective: This study assesses a multi-period capacitated maximal-covering location-allocation model for healthcare services, taking interservice referral as well as equity access into account. Methods: A two-stage optimization strategy is used to formulate the model. In the first stage, facilities are located to maximize covered demand, and in the second stage, patients are allocated to capacitated facilities based on their radius of coverage over multiple time periods. The problem, which belongs to the NP-hard class of optimization problems, is solved using a linear mixed-integer programming (MILP) model. Results: A numerical example is presented to evaluate the efficiency of the proposed model. In addition, to identify near-optimal solutions for large instances, a hybrid genetic-sequential quadratic programming approach (GA-SQP) is developed. To examine the performance and efficiency of the GA-SQP, we employed several randomly generated test instances of various sizes and compared them to those obtained using the exact method. Conclusion: The proposed model has demonstrated an excellent ability in locating healthcare facilities and allocating health services while taking shortage and equity into account during each time period.