Modelling health mobility for equity distribution services in the emergency health sector

In this paper, a model of intraregional patient flow is proposed that dynamically describes patient reorientation following variations in the services offered. The model proposed consists of the development of a capacity-included location–allocation model that integrates a gravitational model for assigning patients to cardiac surgery facilities. As a result of this application, the patient flow does not move only according to the principle of facility proximity; rather, it follows a trajectory based on the coefficients of attraction of each single service. A sensitivity analysis, hypothesising four alternative scenarios in terms of health service capacity offers, was conducted to measure access levels both on the basis of territorial characteristics and on the basis of the total capacity of each unit. The results obtained show that the proposed model can provide more accurate information about the state of the system and about the relative access levels.