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A mixed integer programming model to locate traumatic brain injury treatment units in the Department of Veterans Affairs: a case study

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Abstract

For the Department of Veterans Affairs (VA), traumatic brain injury (TBI) is a significant problem facing active duty military personnel, veterans, their families, and caregivers. The VA has designated TBI treatment as one of its physical medicine and rehabilitation special emphasis programs, thereby providing a comprehensive array of treatment services to those military personnel and veterans with TBI. Timely treatment of TBI is critical in achieving maximal recovery, and being in geographical proximity to a medical center with specialized TBI treatment services is a major determinant of whether such treatment is utilized. We present a mixed integer programming model for locating TBI treatment units in the VA. This model was developed for the VA Rehabilitation Strategic Healthcare Group to assist in locating new TBI treatment units. The optimization model assigns TBI treatment units to existing VA medical centers while minimizing the sum of patient treatment costs, patient lodging and travel costs, and the penalty costs associated with foregone treatment revenue and excess capacity utilization. We demonstrate our model with VA TBI admission data from one of the VA’s integrated service networks, and discuss the expected service and cost implications for a range of TBI treatment unit location options.

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References

  1. National Institutes of Health (1999) Rehabilitation of persons with traumatic brain injury. JAMA 282:974–983

    Article  Google Scholar 

  2. Langlois JA, Rutland-Brown W, Thomas KE (2004) Traumatic brain injury in the United States: emergency department visits, hospitalizations, and deaths. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta

    Google Scholar 

  3. Defense and Veterans Brain Injury Center (2005) How often do blasts result in brain injuries, http://www.dvbic.org/cms.php?p=Blast_injury, accessed online July 29

  4. Defense and Veterans Brain Injury Center (2003) Defense and Veterans Brain Injury Center fact sheet. Walter Reed Army Medical Center, Washington D.C.

    Google Scholar 

  5. Wingert P, Thomas E (2006) On call in hell. Newsweek 147:34–43

    Google Scholar 

  6. Department of Veterans Affairs Office of Inspector General (1999) Oversight review of selected aspects of the Veterans Health Administration’s Traumatic Brain Injury Program, report no. 9HI-A28-119. VA Office of Inspector General, Washington, D.C.

  7. Fong T (2003) An army of patients. Mod Healthc 33:48–50, 62.

    Google Scholar 

  8. DePalma RG, Burris DG, Champion HR, Hodgson MJ (2005) Blast injuries. N Engl J Med 352:1335–1342

    Article  Google Scholar 

  9. Solotaroff P (2006) The hole where Sgt. Thorne’s life used to be. Roll Stone 46–50, 68–69, May 4

  10. Drazen JM (2005) Using every resource to care for our casualties. N Engl J Med 352:2121

    Article  Google Scholar 

  11. Okie S (2005) Traumatic brain injury in the war zone. N Engl J Med 352:2043–2047

    Article  Google Scholar 

  12. Gawande A (2004) Casualties of war—military care for the wounded from Iraq and Afghanistan. N Engl J Med 351:2471–2475

    Article  Google Scholar 

  13. Hoge CW, Auchterlonie JL, Milliken CS (2006) Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. JAMA 295:1023–1032

    Article  Google Scholar 

  14. Miller S (2007) Health body and brain, Minnesota—the magazine of the University of Minnesota Alumni Association 106:24–29

  15. Salazar AM, Zitnay GA, Warden DL, Schwab KA (2000) Defense and veterans head injury program: background and overview. J Head Trauma Rehabil 15:1035–1045

    Google Scholar 

  16. Thurman D, Guerro J (1999) Trends in hospitalization associated with traumatic brain injury. JAMA 282:954–957

    Article  Google Scholar 

  17. Love R, Morris J, Wesolowsky G (1988) Facilities location: models and methods. North-Holland, New York

    Google Scholar 

  18. Cornuéjols G, Nemhauser GL, Wolsey LA (1990) The uncapacitated facility location problem. In: Mirchandani PB, Francis RL (ed) Discrete location theory. Wiley-Interscience, New York

    Google Scholar 

  19. Mehrez A (1996) On the implementation of quantitative facility location models: the case of a hospital in a rural region. J Oper Res Soc 47:612–625

    Article  Google Scholar 

  20. Walsh SJ, Page PH, Gesler WM (1997) Normative models and healthcare planning: network-based simulations within a geographic information system environment. Health Serv Res 32:243–260

    Google Scholar 

  21. Price W, Turcotte M (1986) Locating a blood bank. Interfaces 16:17–26

    Google Scholar 

  22. Schweikhart SB, Smith-Daniels VL (1993) Location and service mix decisions for a managed health care network. Socio-Econ Plann Sci 27:289–302

    Article  Google Scholar 

  23. Branas CC, MacKenzie EJ, ReVelle CS (2000) A trauma resource allocation model for ambulances and hospitals. Health Serv Res 35:489–507

    Google Scholar 

  24. Daskin MS, Dean LK (2004) Location of health care facilities. In: Brandeau ML, Sainfort F, Pierskalla WP (ed) Operations research and health care. Kluwer, Boston

    Google Scholar 

  25. Erlenkotter D (1978) A dual-based procedure for uncapacitated facility location. Oper Res 26:992–1009

    Google Scholar 

  26. Garey MR, Johnson DS (1979) Computers and intractability: a guide to the theory of NP-completeness. Freeman, San Francisco

    Google Scholar 

  27. Righini G (1995) A double annealing algorithm for discrete location/allocation problems. Eur J Oper Res 86:452–468

    Article  Google Scholar 

  28. Koksalan M, Sural H, Kirca O (1995) A location-distribution application for a beer company. Eur J Oper Res 86:16–24

    Article  Google Scholar 

  29. Crainic T, Delorme L (1993) Dual-ascent procedures for multicommodity location-allocation problems with balancing requirements. Transp Sci 27:90–101

    Google Scholar 

  30. Syam S (2002) A model and methodologies for the location problem with logistical components. Comput Oper Res 29:1173–1193

    Article  Google Scholar 

  31. Schrage L (1997) Optimization modeling with LINDO, 5th edn. Duxbury, Pacific Grove

    Google Scholar 

  32. Sorenson S, Kraus J (1991) Occurrence, severity, and outcomes of brain injury. J Head Trauma Rehabil 6:1–10

    Article  Google Scholar 

  33. Teasdale G, Jennett B (1974) Assessment of coma and impaired consciousness. Lancet 2:81–83

    Article  Google Scholar 

  34. Teasdale G, Jennett B (1976) Assessment and prognosis of coma after head injury. Acta Neurochir 34:45–55

    Article  Google Scholar 

  35. Anderson DR, Sweeney DJ, Williams TA (2006) Quantitative methods for business, 10th edn. Thomson South-Western, Mason, OH

    Google Scholar 

  36. Carey K (2000) A multilevel modelling approach to analysis of patient costs under managed care. Health Econ 9:435–446

    Article  Google Scholar 

  37. Carey K, Burgess JF Jr (1999) On measuring the hospital cost/quality trade-off. Health Econ 8:509–520

    Article  Google Scholar 

  38. Huff DL (1966) A programmed solution for approximating optimum retail location. Land Econ 42:293–303

    Article  Google Scholar 

  39. Nakanishi M, Cooper LG (1974) Parameter estimation for a multiple competitive interaction model—least squares approach. J Mark Res XI:303–311

    Article  Google Scholar 

  40. VA to close 3 hospitals and open 2 new ones, The Washington Post May 7, 2004, A09

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Authors and Affiliations

  1. Division of Health Care Policy and Research, Department of Medicine, University of Colorado at Denver and Health Sciences Center, Aurora, CO, 80045, USA

    Murray J. Côté

  2. Department of Management, Marquette University, Milwaukee, WI, 53201, USA

    Siddhartha S. Syam

  3. VA Rehabilitation Outcomes Research Center, Gainesville, FL, 32608, USA

    W. Bruce Vogel & Diane C. Cowper

Authors
  1. Murray J. Côté
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  2. Siddhartha S. Syam
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  3. W. Bruce Vogel
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  4. Diane C. Cowper
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Correspondence to Murray J. Côté.

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Côté, M.J., Syam, S.S., Vogel, W.B. et al. A mixed integer programming model to locate traumatic brain injury treatment units in the Department of Veterans Affairs: a case study. Health Care Manage Sci 10, 253–267 (2007). https://doi.org/10.1007/s10729-007-9018-7

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  • DOI: https://doi.org/10.1007/s10729-007-9018-7

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