Balanced service provision
In Chapter 4 you learned about ways of choosing one option from many. In Chapter 7 you learned about ways of determining the appropriate levels of resource or activity for a particular service, the implicit assumption being that the necessary resources could be found, at least in the medium term. However, where there are limits to the availability of resources, doing more of one thing will generally mean doing less of another. In this chapter you will consider the question of how to achieve the best mix or balance of service provision when resources are limited. Decision makers may have to address questions such as: given the resources available, the health needs or demands of the population served, and the scope for altering the balance of provision, which services should be provided? How much of each type of service should be provided? Where do the resource bottlenecks arise? And what will be gained by relieving a given bottleneck?
By the end of this chapter, you will be better able to:
• explain the circumstances in which 'best mix' problems arise in health
• describe the linear programming formulation of this type of problem • assess the strengths and weaknesses of one type of model designed to
support health care planning decisions
Constraints Upper or lower limits on the level of a particular activity.
Feasible region All the possible combinations of values of a variable that are consistent with a
given set of constraints.
Linear programming An approach to finding feasible and, in particular, the best solutions
when the constraints and objective function are linear.
Objective function A mathematical function of the values of a variable which represents an
objective to be either maximized (e.g. health gain) or minimized (e.g. cost).