A hierarchical location model for determining capacities of neonatal intensive care units in Korea

• Published in: Socio-economic planning sciences Vol. 68; p. 100695
• Main Authors: Jang, Hoon, Lee, Jun-Ho
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.12.2019; Elsevier Science Ltd
• Subjects: Access; Allocation; Facility location problem; Health care; Health care delivery; Health care policy; Hierarchical location model; Hierarchies; Infants; Intensive care; Mathematical models; Neo-natal care system; Neonatal care; Neonatal units; Neonatology; Newborn babies; Optimization; Policy making; Property; Queueing; Queuing theory; Transportation; South Korea; Neo-natal care system; Queuing theory; Facility location problem; Hierarchical location model; Optimization
• ISSN: 0038-0121; 1873-6041
• DOI: 10.1016/j.seps.2019.03.001

Reforming the healthcare delivery system to provide optimum care to sick newborn infants is a critical task in Korea. Motivated by the efforts of the Korean government, we study a capacity allocation model to design an optimal capacity allocation plan for neonatal intensive care units (NICUs). Our model considers the following properties: 1) the hierarchical feature of neonatal care services and 2) the congestion effect in NICU operations. We develop a mathematical model that combines a hierarchical location model with queuing theory. We subsequently apply the proposed model to the problem of allocating capacities to NICUs in Korea. We provide information that can help policymakers draw an initial plan by evaluating various capacity allocation scenarios. We further examine two policy alternatives for improving accessibility to neonatal care. One involves increasing service capacity by adaptively adding resources to NICUs, and the other includes expanding physical service coverage by introducing helicopter transport. The results show that each alternative can contribute toward improving accessibility, and we believe that these findings will have practical implications for developing a better neonatal care system. •We develop a hierarchical location model to design a location plan of neonatal care capacities in Korea.•We consider the hierarchical properties and probabilistic nature of the neonatal care system.•We apply our model to the design of the neonatal care system in Korea.•We examine two plausible policy options which can be considered in order to build a better neonatal care system.