Article ID: | iaor2007268 |
Country: | Netherlands |
Volume: | 9 |
Issue: | 1 |
Start Page Number: | 19 |
End Page Number: | 30 |
Publication Date: | Feb 2006 |
Journal: | Health Care Management Science |
Authors: | Bevan Gwyn, Oliveira Mnica Duarte |
Keywords: | location, behaviour |
Policies that seek to achieve geographic equity in countries with a National Health Service (NHS) require information on how to change the distribution of supply to achieve greater equity in access and utilisation. Previous methods for analysing the impact of hospital changes have relied on crude assumptions on patients' behaviour in using hospitals. The approach developed in this study is a multi-modelling one based on two mathematical programming location-allocation models to redistribute hospital supply using different objective functions and assumptions about the utilisation behaviour of patients. These models show how different policy objectives seeking equity of geographic access or utilisation produce different results and imply trade-offs in terms of reduction in total utilisation.