Abstract
A mobile stroke unit (MSU) is an ambulance, where stroke patients can be diagnosed and treated. Recently, placement of MSUs has been studied focusing on either maximum population coverage or equal service for all patients, termed efficiency and equity, respectively. In this study, we propose an unconstrained optimization model for the placement of MSUs, designed to introduce a tradeoff between efficiency and equity. The tradeoff is based on the concepts of weighted average time to treatment and the time difference between the expected time to treatment for different geographical areas. We conduct a case-study for Sweden’s Southern Health care Region (SHR), generating three scenarios (MSU1, MSU2, and MSU3) including 1, 2, and 3 MSUs, respectively. We show that our proposed optimization model can tune the tradeoff between the efficiency and equity perspectives for the MSU(s) allocation. This enables a high level of equal service for most inhabitants, as well as reducing the time to treatment for most inhabitants of a geographic region. In particular, placing three MSUs in the SHR with the proposed tradeoff, the share of inhabitants who are expected to receive treatment within an hour potentially improved by about a factor of 14 in our model.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
World Stroke Organization. https://www.world-stroke.org/world-stroke-day-campaign/why-stroke-matters/learn-about-stroke/. Accessed 20 Dec 2019
Ebinger, M., Winter, B., Wendt, M., Weber, JE., Waldschmidt, C., Rozanski, M., Kunz, A., Koch, P., Kellner, PA., Gierhake, D.: Effect of the use of ambulance-based thrombolysis on time to thrombolysis in acute ischemic stroke: a randomized clinical trial. JAMA 311(16), 1622–1631
Phan, TG., Beare, R., Srikanth, V., Ma, H.: Googling location for mobile stroke unit hub in metropolitan Sydney. Front. Neurol. 10, 810 (2019)
Rhudy Jr, P., Alexandrov, A.W., Rike, J., Bryndziar, T., Maleki, A.H.Z., Swatzell, V., Dusenbury, W., Metter, E.J., Alexandrov, A..V.: Geospatial visualization of mobile stroke unit dispatches: a method to optimize service performance. Intervent. Neurol. 7(6), 464–470 (2018)
Mathur, S., Walter, S., Grunwald, I.Q., Helwig, S.A., Lesmeister, M., Fassbender, K.: Improving prehospital stroke services in rural and underserved settings with mobile stroke units. Front. Neurol. 10 (2019)
Drezner, T., Drezner, Z.: Equity models in planar location. Comput. Manage. Sci. 4 (1), 1–16 (2007)
Drezner, T., Drezner, Z.: A note on equity across groups in facility location. Nav. Res. Logist. (NRL) 58(7), 705–711 (2011)
Mulligan, G.F.: Equality measures and facility location. Pap. Region. Sci. 70(4), 345–365 (1991)
Toro-Díaz, H., Mayorga, M.E., McLay, L.A., Rajagopalan, H.K., Saydam, C.: Reducing disparities in large-scale emergency medical service systems. J. Oper. Res. Soc. 66(7), 1169–1181 (2015)
Enayati, S., Mayorga, M.E., Toro‐Díaz, H., Albert, L.A.: Identifying trade‐offs in equity and efficiency for simultaneously optimizing location and multipriority dispatch of ambulances. Int. Trans. Oper. Res. 26(2), 415–438 (2019)
Espejo, I., Marín, A., Puerto, J., Rodríguez-Chía, A.M.: A comparison of formulations and solution methods for the minimum-envy location problem. Comput. Oper. Res. 36(6), 1966–1981 (2009)
Chanta, S., Mayorga, ME., McLay, L.A.: Improving emergency service in rural areas: a bi-objective covering location model for EMS systems. Ann. Oper. Res. 221(1), 133–159 (2014)
Dahllöf, O., Hofwimmer, F., Holmgren, J., Petersson, J.: Optimal placement of mobile stroke units considering the perspectives of equality and efficiency. Proc. Comput. Sci. 141, 311–318 (2018)
Amouzad Mahdiraji, S., Dahllöf, O., Hofwimmer, F., Holmgren, J., Mihailescu, R.-C., Petersson, J.: Mobile stroke units for acute stroke care in the south of Sweden. Cogent Eng. 8(1) (2021). https://doi.org/10.1080/23311916.2021.1874084
Statistics Sweden. https://www.scb.se/. Accessed 10 July 2018
Sweden’s Southern Regional Health Care Committee. https://sodrasjukvardsregionen.se/. Accessed 10 July 2018
Funding
This work was partially funded by Sweden’s Southern Regional Health Care Committee and The Kamprad Family Foundation for Entrepreneurship, Research & Charity.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
About this paper
Cite this paper
Mahdiraji, S.A., Holmgren, J., Mihailescu, RC., Petersson, J. (2021). An Optimization Model for the Tradeoff Between Efficiency and Equity for Mobile Stroke Unit Placement. In: Chen, YW., Tanaka, S., Howlett, R.J., Jain, L.C. (eds) Innovation in Medicine and Healthcare. Smart Innovation, Systems and Technologies, vol 242. Springer, Singapore. https://doi.org/10.1007/978-981-16-3013-2_15
Download citation
DOI: https://doi.org/10.1007/978-981-16-3013-2_15
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-16-3012-5
Online ISBN: 978-981-16-3013-2
eBook Packages: Intelligent Technologies and RoboticsIntelligent Technologies and Robotics (R0)