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An Optimization Model for the Tradeoff Between Efficiency and Equity for Mobile Stroke Unit Placement

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Innovation in Medicine and Healthcare

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.

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Funding

This work was partially funded by Sweden’s Southern Regional Health Care Committee and The Kamprad Family Foundation for Entrepreneurship, Research & Charity.

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Correspondence to Saeid Amouzad Mahdiraji .

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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

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