The Capacitated Maximal Covering Location Problem Improves Access to Stroke Treatment: A Cross-Sectional Simulation...

Area of Science:

• Healthcare policy
• Medical geography
• Stroke treatment optimization

Background:

• Disparities in advanced stroke treatment access pose a significant policy challenge globally.
• Limited healthcare resources necessitate practical solutions for equitable treatment distribution.
• Mechanical thrombectomy (MT) is a critical advanced stroke treatment.

Purpose of the Study:

• To evaluate the supply and demand balance for MT in Hokkaido, Japan.
• To identify priority areas for enhancing stroke centers.
• To propose an optimal allocation of MT services without increasing medical facilities.

Main Methods:

• Utilized the capacitated maximal covering location problem (CMCLP) model.
• Simulated four scenarios with varying MT supply capacities and travel times (90 minutes).
• Analyzed demand coverage and supply-demand balance.

Main Results:

• Coverage increased from approximately 53% to 85% across scenarios 1-4.
• Scenarios 2 and 3 showed a 5% oversupply, while scenario 4 had a 20% oversupply.
• Eight primary stroke centers (PSCs) receiving 31+ patients were identified as priority enhancement targets.

Conclusions:

• The CMCLP effectively estimates demand coverage and identifies areas for MT supply capacity enhancement.
• Strategic resource allocation can improve MT access and address healthcare disparities.
• Prioritizing specific stroke centers is crucial for optimizing MT service delivery.