Transportation or CT scanners: a theory and method of health resources allocation

Cost containment and access to appropriate care are the two most frequently discussed issues in contemporary health policy. Conceiving of the health services available in specific regions as "packages" of diverse items, the authors of this article consider the economic trade-offs among the various resources needed for appropriate care. In the discussion that follows, we examine the trade-offs between two divergent offering of the health care system: high technology medicine and support services. Specifically, we examine several strategies designed to achieve an optimal mix of investments in CT scanners and transportation resources in the South Chicago region. Using linear programming as a method for examining these options, the authors found that 1) the proper location of CT scanners is as important for cost containment as optimal number, and 2) excess capacity in the utilization of a single resource--CT scanners--need not imply inefficiency in the overall delivery of the service. These findings help demonstrate the importance of viewing health care as a package of interrelated services, both for achieving cost containment and for providing access to appropriate care.