Siting Primary Care Clinics To Meet Daytime And After-hours Objectives

Abstract

Location science is used to determine the optimal geographical placement of primary care resources with operations research models. In determining the optimal placement, we account for the objectives of both patients and physicians. Patients prefer to be close to clinics to ensure access and physicians typically prefer to have minimum panel sizes to ensure consistent appointments. These objectives and the methods used to address them differ between daytime and after-hours settings. Three approaches are considered to address both time settings: independent, sequential, and simultaneous. The independent approach is based on the p-Median problem, and the other two approaches use modified forms of the p-Median. The models are generalized and applied to census data from Nova Scotia. Three case studies are examined using Canadian census data from Halifax, Cape Breton, and modified data in Cape Breton. The regular-to-after-hours approach is found to most frequently be the worst, while the simultaneous approach yields the best results while considering facility-sharing constraints.