Primary health-care network monitoring: a hierarchical resource allocation modeling approach

Management of a primary health-care network (PHCN) is a difficult task in every country. A suitable monitoring system can provide useful information for PHCN management, especially given a large quantity of health-care data that is produced daily in the network. This paper proposes a methodology for structured development of monitoring systems and a PHCN resource allocation monitoring model based on this methodology. The purpose of the monitoring model is to improve the allocation of health-care resources. The proposed methodology is based on modules that are organized into a hierarchy, where each module monitors a particular aspect of the system. This methodology was used to design a PHCN monitoring model for Slovenia. Specific aspects of the Slovenian PHCN were taken into account such as varying needs of patients from different municipalities, existence of small municipalities having less than 1000 residents, the fact that many patients visit physicians in other municipalities, and that physicians may work at more than one location or organization. The main modules in the model are focused on the overall assessment of the PHCN, monitoring of patients visits to health-care providers (HCPs), physical accessibility of health services, segment of patients in municipalities who have not selected a personal physician, assessment of the availability of HCPs for patients, physicians working on more than one location, and available human resources in the PHCN. Most of the model's components are general and can be adapted for other national health-care systems.