Preventive Healthcare Facility Research Articles

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

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

Sex and gender affect immune aging

The proposed review aims to elucidate the intricate interplay between biological factors (sex differences) and socially constructed factors (gender differences) in the context of immune aging. While the influence of biological differences between men and women on various aspects of immune responses has long been recognized, it is crucial to acknowledge that gender, encompassing the social and cultural roles and expectations associated with being male or female, also significantly shapes these processes. Gender can either accelerate immune aging or promote longevity. By recognizing the impact of both biological and social factors, this work seeks to offer a comprehensive understanding of why men and women may experience divergent trajectories in immune aging and varying outcomes in terms of longevity. Discrepancies in perceived roles of the sexes, both within families and at work, contribute to differing patterns of antigen exposure. Additionally, variations in micronutrient intake and access to preventive healthcare facilities may exist. Health promotion knowledge often correlates with educational attainment, which is unequally represented between males and females in many cultures and across generations in the Western world. In countries without a universal healthcare system, access to healthcare relies on family prioritization strategies to cope with economic constraints, potentially limiting access to specific treatments and affecting immune responses negatively. As a result, both biological factors and social and behavioral factors associated with gender contribute to disparities in immune responses, susceptibility to infections, autoimmune diseases, and vaccine responses among older individuals. However, as demonstrated by the COVID-19 pandemic, older females exhibit greater resilience to infections than older males. Given the crucial role of the immune system in achieving longevity, it is not surprising that women live longer than men, and the number of female centenarians surpasses that of male centenarians.

IMPLEMENTATION OF THE HOSPITAL DISTRICT FOR THE MEDICAL INSTITUTIONS: MEDICAL AND SOCIAL JUSTIFICATION OF THE FINANCIAL AND ECONOMIC STATE OF KALUSH CENTRAL DISTRICT HOSPITAL BEFORE AND AFTER IMPLEMENTATION

The aim: To determine the financial and economic condition before and after the implementation of the hospital district in the Kalush Central District Hospital and to show the medical and social justification of the changes in the institution's finances. Materials and methods: The object of this study was the activity of the Kalush Central District Hospital, which is a multidisciplinary medical and preventive health care facility, in which medical assistance is provided to patients in surgical, neurosurgical, traumatological, cardiological, gastroenterological, endocrinological, urological departments, in the department of miniinvasive surgery. In order to see how the implementation of hospital districts a"ected the financial condition of medical institutions, the financial statements of the institution for 2017-2018 were used to study the financial condition of the organization. During this period medical assistance was provided to more than 92,000 patients. Results: The reform of the health care system in 2017 took place in accordance with the developed concept of the development of medicine, which is based on the creation of hospital districts. On average, the hospital district covers about 60 kilometers of territory. Such a distance allows us to deploy a powerful network of various hospitals that are able to provide almost the entire range of medical services, starting from diagnostics and ending with urgent treatment. The hospital district is headed by an institution that coordinates the work of all institutions and recommends building such organizational and financial structures that allow the medical institution to develop and create a quality medical product. Kalush Central District Hospital coped with the reforms of medicine, the implementation of hospital districts became a significant event that changed not only the organization of the provision of medical services, but also changes in the financial and economic condition of medical institutions. In general, the financial condition of the enterprise shows that the hospital is autonomic, it is financed from its own sources of financing. Conclussions: The financial condition of the enterprise shows that the Kalush Central District Hospital is autonomous, that is, to a greater extent, it is financed from its own sources of financing. However, liquidity indicators are negative, which require more e"ective management of cash #ows so that the organization can timely repay salary arrears and pay mandatory payments for the use of material resources and energy. At the same time, a large number of patients are coming to the hospital because the income level has increased, which is definitely a positive factor. However, when planning activities for the following periods, it is necessary to take into account the need to update material and technical support, as well as to find sources of increasing sta" wages.

Location and capacity planning for preventive healthcare facilities with congestion effects

<p style="text-indent:20px;">A painful lesson got from pandemic COVID-19 is that preventive healthcare service is of utmost importance to governments since it can make massive savings on healthcare expenditure and promote the welfare of the society. Recognizing the importance of preventive healthcare, this research aims to present a methodology for designing a network of preventive healthcare facilities in order to prevent diseases early. The problem is formulated as a bilevel non-linear integer programming model. The upper level is a facility location and capacity planning problem under a limited budget, while the lower level is a user choice problem that determines the allocation of clients to facilities. A genetic algorithm (GA) is developed to solve the upper level problem and a method of successive averages (MSA) is adopted to solve the lower level problem. The model and algorithm is applied to analyze an illustrative case in the Sioux Falls transport network and a number of interesting results and managerial insights are provided. It shows that solutions to medium-scale instances can be obtained in a reasonable time and the marginal benefit of investment is decreasing.</p>

Preventive healthcare facility location planning with quality-conscious clients

Pursuing the overarching goal of saving both lives and healthcare costs, we introduce an approach to increase the expected participation in a preventive healthcare program, e.g., breast cancer screening. In contrast to sick people who need urgent medical attention, the clients in preventive healthcare decide whether to go to a specific facility (if this maximizes their utility) or not to take part in the program. We consider clients’ utility functions to include decision variables denoting the waiting time for an appointment and the quality of care. Both variables are defined as functions of a facility’s utilization. We employ a segmentation approach to formulate a mixed-integer linear program. Applying GAMS/CPLEX, we optimally solved instances with up to 400 demand nodes and 15 candidate locations based on both artificial data as well as in the context of a case study based on empirical data within one hour. We found that using a Benders decomposition of our problem decreases computational effort by more than 50%. We observe a nonlinear relationship between participation and the number of established facilities. The sensitivity analysis of the utility weights provides evidence on the optimal participation given a specific application (data set, empirical findings).

Using mathematical modeling for analysis of the impact of client choice on preventive healthcare facility network design

ABSTRACT Increasing people participation in preventive healthcare programs can improve the quality of their life and create a lot of saving. Governments can more effectively utilize their healthcare expenditures, as well. Usually, governments do not make it mandatory for people to participate in these programs but encourage them. It is necessary to design the network of preventive healthcare facilities optimally based on client choice and requirements for increasing the participation of people in such programs. Therefore, this research focuses on two models of probabilistic selection and optimal selection as different client choice for predicting and managing the preventive services networks. The limits of waiting time and the workload of each facility are also considered for ensuring the quality of care. The main characteristics of the network configuration in this paper are the number of facilities, their location, and capacity. Both models are formulated using mixed integer linear programming and a genetic algorithm is utilized in the high dimensions problems for solving them effectively and quickly. These models are implemented for actual data of Isfahan city and then their results are analyzed. The results demonstrate a significant impact of the client choice on network efficiency.

A model for locating preventive health care facilities

In this paper, we focus on the problem of locating preventive health care (PHC) facilities. The most important factors that promote participation rates in PHC programs include the establishment of an appropriate infrastructure and the provision of a satisfactory quality of care. For this purpose, we develop a strategic level multi-objective mixed integer linear programming model for locating PHC facilities to ensure maximum participation and provide timely service to potential clients. We, then, apply the model to a case study of locating Cancer Early Diagnosis, Screening and Training Centers in Istanbul, Turkey and solve it considering the forecasted population of each district in Istanbul for the next 15 years. We also perform a sensitivity analysis to quantify the effect of different weighting strategies on the value of each term in the objective function.

Biomedical Applications Based on Mobile Phone Cell Network Systems

The paper focuses on the functionality and effectiveness of wireless mobile medical devices in tele-biomedical applications with the development of mobile wireless techniques. Medical implementation is a field for supporting the future of wireless networking. A patient who is remotely situated can be treated remotely by communicating their status to caregivers in real-time. The e-healthcare devices were created mainly to observe physiological parameters such as body temperature, level of oxygen saturation, heart rate, amount of blood sugar, blood pressure, etc. With the development of wireless technologies, however, there has been a variety of variations and improvements in e-healthcare systems. Tele-biomedical apps with wireless networks for mobile communications such as telemedicine is a distant medical practice that enables cooperation between distinct people and promotes their collaborative attempts to diagnose or treat illness through IT and telecommunications. Medical servers and databases are remote computers that assist medical personnel and hospitals analyze and monitor vital signs and provide patients with adequate facilities in real time. The tele-biomedical environment is a general word used for the use of mobile phones (handheld devices) and other wireless systems and communication devices to inform users or customers of medical preventive healthcare facilities. The scheme launched applications that can adapt to other illnesses, including elevated BP, diabetes and fever, through biometric devices such as thermometers, glucometers and densitometers to transmit patient data from an Android application based on the user's sensitivity to a social media scheme, such as a software application to monitor children's vaccination coverage.

Multi-objective evolutionary algorithms for a preventive healthcare facility network design

Multi-objective evolutionary algorithms for a preventive healthcare facility network design

ИССЛЕДОВАНИЕ УСЛОВИЙ, ФАКТОРОВ И ТЕНДЕНЦИЙ РАЗВИТИЯ МЕЖДУНАРОДНОГО РЫНКА МЕДИЦИНСКИХ УСЛУГ

Medical service is a process of interaction between a doctor and a patient in order to improve health outcomes. The quality of medical services is influenced by various factors: a lack of equipment in the preventive health care facilities, pharmaceutical products supply, coordination of appointments of the patients, etc.). Accordingly, there appears a tendency to increase the demands for provision of medical services. The social significance of healthcare services renders the process of their provision as the category of mandatory measures for governmental control and regulation in all countries, with the purpose to provide access for all strata of the population and maintain the appropriate quality level. Therefore, the standards of medical services have become the main line of activity for many specialized international organizations and governments (personnel requirements, medical products and medicines, regulation of medical insurance, etc.). In turn, standardization creates significant entry barriers in the market of medical services. The need of implementing international and national standards for the provision of medical services and their convergence are stipulated by the specificity of the healthcare sector. International medical service trade, implementation of telemedicine technologies and innovative methods of treatment, standardization of production and consumption of medical services are modern trends that lead to the formation of the international market for medical services. The provision of medical services to patients of other countries in more than 50 countries is defined as one of the main directions of national development. Since the cost factor is an important determinant of competitiveness, patients from countries with highly developed health care system go to developing countries where they receive medical services of good quality at lower prices. In light of the above, the article analyzes the stages of development of the medical service market depending on the level of economic development, preconditions for developing competitive advantages and the global factors that shape the trends of development of the international market of medical services.

The impact of directed choice on the design of preventive healthcare facility network under congestion.

Preventive healthcare (PH) programs and services aim at reducing the likelihood and severity of potentially life-threatening illness by early detection and prevention. The effectiveness of these programs depends on the participation level and the accessibility of the users to the facilities providing the services. Factors that impact the accessibility include the number, type, and location of the facilities as well as the assignment of the clients to these facilities. In this paper, we study the impact of system-optimal (i.e., directed) choice on the design of the preventive healthcare facility network under congestion. We present a model that simultaneously determines the location and the size of the facilities as well as the allocation of clients to these facilities so as to minimize the weighted sum of the total travel time and the congestion associated with waiting and service delay at the facilities. The problem is set up as a network of spatially distributed M/G/1 queues and formulated as a nonlinear mixed integer program. Using simple transformation of the nonlinear objective function and piecewise linear approximation, we reformulate the problem as a linear model. We present a cutting plane algorithm based exact (𝜖-optimal) solution approach. We analyze the tradeoff between travel time and queuing time and its impact on the location and capacity of the facilities as well as the allocation of clients to these facilities under a directed choice policy. We present a case study that deals with locating mammography clinics in Montreal, Canada. The results show that incorporating congestion in the PH facility network design substantially reduces the total time spent by clients. The proposed model allows policy makers to direct clients to facilities in an equitable manner resulting in better accessibility.

Insights into clients’ choice in preventive health care facility location planning

In this contribution we build on the approach proposed by Zhang et al. (OR Spectrum 34:349---370, 2012) to consider clients' choice in preventive health care facility location planning. The objective is to maximize the participation in a preventive health care program for early detection of breast cancer in women. In order to account for clients' choice behavior the multinomial logit model is employed. In this paper, we show that instances up to 20 potential locations and 400 demand points can be easily solved (to optimality or at least close to optimality) by a commercial solver in reasonable time if the problem is modeled by an alternative formulation. We present an intelligible approach to derive a lower bound to the problem. Our paper provides interesting insights into the trade-off between minimum workload requirement (to ensure quality of care) and participation (and thus early diagnosis of disease). We present a general definition of clients' utility (which allows for clients' characteristics, for example) and discuss some fundamental issues (and pitfalls) concerning the specification of utility functions.

The impact of client choice on preventive healthcare facility network design

In contrast with sick people who need urgent medical attention, the clientele of preventive healthcare have a choice in whether to participate in the programs offered in their region. In order to maximize the total participation to a preventive care program, it is important to incorporate how potential clients choose the facilities to patronize. We study the impact of client choice behavior on the configuration of a preventive care facility network and the resulting level of participation. To this end, we present two alternative models: in the "probabilistic-choice model" a client may patronize each facility with a certain probability, which increases with the attractiveness of the available facilities. In contrast, the "optimal-choice model" stipulates that each client will go to the most attractive facility. In this paper, we assume that the proximity to a facility is the only attractiveness attribute considered by clients. To ensure the quality of care, we impose a bound on the mean waiting time as well as a minimum workload requirement at each open facility. Subject to a total capacity limit, the number of open facilities as well as the location and the capacity (number of servers) of each open facility is the main determinant of the configuration of a facility network. Both models are formulated as a mixed-integer program. To solve the problems efficiently, we propose a probabilistic search algorithm and a genetic algorithm. Finally, we use the models to analyze the network of mammography centers in Montreal.

A bilevel model for preventive healthcare facility network design with congestion

Preventive healthcare aims at reducing the likelihood and severity of potentially life-threatening illnesses by protection and early detection. The level of participation in preventive healthcare programs is a critical determinant in terms of their effectiveness and efficiency. This article presents a methodology for designing a network of preventive healthcare facilities so as to improve its accessibility to potential clients and thus maximize participation in preventive healthcare programs. The problem is formulated as a mathematical program with equilibrium constraints; i.e., a bilevel non-linear optimization model. The lower level problem which determines the allocation of clients to facilities is formulated as a variational inequality; the upper level is a facility location and capacity allocation problem. The developed solution approach is based on the location–allocation framework. The variational inequality is formulated as a convex optimization problem, which can be solved by the gradient projection method; a Tabu search procedure is developed to solve the upper level problem. Computational experiments show that large-sized instances can be solved in a reasonable time. The model is used to analyze an illustrative case, a network of mammography centers in Montreal, and a number of interesting results and managerial insights are discussed, especially about capacity pooling.

Optimization of preventive health care facility locations.

BackgroundPreventive health care programs can save lives and contribute to a better quality of life by diagnosing serious medical conditions early. The Preventive Health Care Facility Location (PHCFL) problem is to identify optimal locations for preventive health care facilities so as to maximize participation. When identifying locations for preventive health care facilities, we need to consider the characteristics of the preventive health care services. First, people should have more flexibility to select service locations. Second, each preventive health care facility needs to have a minimum number of clients in order to retain accreditation.ResultsThis paper presents a new methodology for solving the PHCFL problem. In order to capture the characteristics of preventive health care services, we define a new accessibility measurement that combines the two-step floating catchment area method, distance factor, and the Huff-based competitive model. We assume that the accessibility of preventive health care services is a major determinant for participation in the service. Based on the new accessibility measurement, the PHCFL problem is formalized as a bi-objective model based on efficiency and coverage. The bi-objective model is solved using the Interchange algorithm. In order to accelerate the solving process, we implement the Interchange algorithm by building two new data structures, which captures the spatial structure of the PHCFL problem. In addition, in order to measure the spatial barrier between clients and preventive health care facilities accurately and dynamically, this paper estimates travelling distance and travelling time by calling the Google Maps Application Programming Interface (API).ConclusionsExperiments based on a real application for the Alberta breast cancer screening program show that our work can increase the accessibility of breast cancer screening services in the province.

Incorporating congestion in preventive healthcare facility network design

Preventive healthcare aims at reducing the likelihood and severity of potentially life-threatening illnesses by protection and early detection. The level of participation to preventive healthcare programs is a crucial factor in terms of their effectiveness and efficiency. This paper provides a methodology for designing a network of preventive healthcare facilities so as to maximize participation. The number of facilities to be established and the location of each facility are the main determinants of the configuration of a healthcare facility network. We use the total (travel, waiting and service) time required for receiving the preventive service as a proxy for accessibility of a healthcare facility, and assume that each client would seek the services of the facility with minimum expected total time. At each facility, which we model as an M/M/1 queue so as to capture the level of congestion, the expected number of participants from each population zone decreases with the expected total time. In order to ensure service quality, the facilities cannot be operated unless their level of activity exceeds a minimum workload requirement. The arising mathematical formulation is highly nonlinear, and hence we provide a heuristic solution framework for this problem. Four heuristics are compared in terms of accuracy and computational requirements. The most efficient heuristic is utilized in solving a real life problem that involves the breast cancer screening center network in Montreal. In the context of this case, we found out that centralizing the total system capacity at the locations preferred by clients is a more effective strategy than decentralization by the use of a larger number of smaller facilities. We also show that the proposed methodology can be used in making the investment trade-off between expanding the total system capacity and changing the behavior of potential clients toward preventive healthcare programs by advertisement and education.

Marketing macroenvironment of a sanatorium and spa facility as a study object and a factor of strategic decision making

Analysis of marketing macroenvironment is an important stage in the formulation of the strategy for the development and operation of a therapeutic and preventive healthcare facility making possible rapid adjustment to sharply changing marketing conditions. The possibility of using expert evaluation for the analysis of the marketing macroenvironment of a sanatorium and spa facility and a concrete medical care service provided (peloidotherapy) is illustrated. The study covers five aspects of marketing macroenvironment, viz. socio-demographic, technological, economic, political and ecological.

Location of Preventive Health Care Facilities

This paper is focused on the problem of locating preventive health care facilities. The aim is to maximize participation to prevention programs. We assume that distance is a major determinant of participation and people would go to the closest facility for preventive health care. Each facility is required to have more than a predetermined number of clients because of the direct relationship between volume and quality of preventive services. We provide a mathematical formulation and present alternative solution approaches for this new location problem. We report on computational performance of the proposed methods in locating public health centers in Fulton County, Georgia and mammography screening centers in Montreal, Quebec.