The Regional Planning of Health Care Services: RAMOS and RAMOS-1

Mayhew, L.D. (1980). The Regional Planning of Health Care Services: RAMOS and RAMOS-1. IIASA Working Paper. IIASA, Laxenburg, Austria: WP-80-166

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Abstract

This working paper is the second in a series on RAMOS (Resource Allocation Model Over Space), dealing with the effects on in-patient hospitalization rates of changing resource levels, population trends, and accessibility costs in heavily populated or congested regions. Whereas the first paper emphasized and detailed the empirical basis, calibration, and validation of RAMOS, the material presented here examines its application in a decision-making context. For simplicity, two levels in the planning process are identified: the tactical and the strategic. For each level a different approach for using RAMOS is recommended. In the first case, it is argued that the planning problems are relatively self-contained, and they can be analyzed in only a few computer runs of the model. In the second case, the possibilities are unrealistically many and so must be narrowed down. To tackle this a new version of the model RAMOS^{-1} is developed and tested in detail. The objective in RAMOS^{-1} is to pick resource configurations such that the relative needs of the population in each place of residence in a region are met. However, so that other objectives in the health care system do not conflict in the process, upper and lower bounds on permissible resource allocations are introduced in each treatment-district zone. The problem is solved using a quadratic programming technique and applying it to four, hypothetical planning scenarios using data based on London, in southeast England. A sensitivity analysis is also conducted on the model parameter, before some conclusions are drawn and recommendations for further developments are made.

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