Primary Health Care Facility Location and Telemedicine

A major challenge for achieving universal health care is to sustain balanced primary care access in society. In highly populated developing countries like India, a low-cost approach is inevitable. Telemedicine can be highly beneficial to address this concern. Moreover, the growing demand for health care in epidemics like COVID-19 has also promoted the usage of teleconsultation. This article presents a framework for incorporating telemedicine services to strengthen the existing primary health care network. An integer linear programming-based optimization model has been developed for locating primary care facilities in the presence of functioning telemedicine services. The objective would be to find a trade-off between the location of new primary health care facilities and the usage of telemedicine services for primary health care. Numerical experiments and a case study have been carried out to explain the working of the model and to derive policy directions. While performing sensitivity analysis concerning budget, it was observed that teleconsultation services outweigh new primary care facilities. Moreover, increasing the levels of capacity by 50% over existing capacity levels resulted in complete coverage. By conducting a case study in the northeast district of Delhi, it was found that complete coverage could not be achieved and therefore, new sites for primary care centers along with new teleconsultation services are required to be identified.