Patient flows and optimal health-care resource allocation at the macro-level: a dynamic linear programming approach

In this paper we present a deterministic allocation model in which a patient's health-state changes due to health-care interventions. This change in a patient's health-state has a direct effect on the patient's expected future need for health-care. Hence, current allocation decisions determine to some extent the set of possible allocation decisions in the future. In order to take this into account we have formulated a dynamic linear programming version of a patient-flow system. This enables us to describe the effects of using different objective functions on the optimum level and composition of the provision of health services within given resource constraints. The linear programming approach enables the quantification of the health effects and therefore the desirability of the (re-)allocation of health-care resources. We provide some simulation results in order to illustrate the working of the model.