Optimization of periodic care locations to improve equity of specialty care services

Abstract

Specialty medical care is often less accessible for patients from rural, remote or sequestered areas where the opportunity to access advanced but necessary care is not available locally. We present a location model for periodic specialty care (e.g., traveling specialty care providers, telemedicine clinics, pop-up clinics for uninsured patients, mobile mammography screening) to increase access. The model considers the distribution of rural patients and aims to optimize the clinic location decisions while maximizing patient participation in care. The model assumes that the patients can choose the central hospital or a periodic care clinic to receive specialty services, and participation is negatively affected by distance. We present a specific case using the model to locate telemedicine procedure clinics in Virginia to increase access and adherence to bladder cancer screening.