Evidence-Based Planning of High-Complexity Healthcare Networks at National Level: Integrating Mortality Records, Accessibility Metrics, and Facility Location Optimization Models.

This study presents a four-step methodology to analyze and improve the provision of high-complexity healthcare services (HCHS) at national level: (i) data analysis and identification of municipalities with a concentration of HCHS provision, referred to as supplier municipalities; (ii) measurement of accessibility to supplier municipalities; (iii) identification of new facility locations through optimization techniques; and (iv) determination of the level of service provision required at the new locations. The proposed methodology is applied to the case of Colombia, where 65.25% of deaths occur in medical facilities. An analysis of the national database shows that in supplier municipalities, 92.8% of residents die in the same municipality, whereas in other municipalities this proportion decreases to 55.2%, indicating travel patterns among critically ill patients to supplier municipalities. Optimization methods are then used to identify locations for new HCHS facilities; the addition of 10 new locations improves coverage for 3,842,920 inhabitants within a 120 km range of HCHS.