A hierarchical location model for determining capacities of neonatal intensive care units in Korea

Reforming the healthcare delivery system to provide optimum care to sick newborn infants is a critical task in Korea. Motivated by the efforts of the Korean government, we study a capacity allocation model to design an optimal capacity allocation plan for neonatal intensive care units (NICUs). Our model considers the following properties: 1) the hierarchical feature of neonatal care services and 2) the congestion effect in NICU operations. We develop a mathematical model that combines a hierarchical location model with queuing theory. We subsequently apply the proposed model to the problem of allocating capacities to NICUs in Korea. We provide information that can help policymakers draw an initial plan by evaluating various capacity allocation scenarios. We further examine two policy alternatives for improving accessibility to neonatal care. One involves increasing service capacity by adaptively adding resources to NICUs, and the other includes expanding physical service coverage by introducing helicopter transport. The results show that each alternative can contribute toward improving accessibility, and we believe that these findings will have practical implications for developing a better neonatal care system.