A stochastic programming model for trauma hospital network expansion considering rural communities and COVID-19

Trauma care services are a vital part of all healthcare-based networks as timely accessibility is important for citizens. Trauma care access is even more relevant when unexpected events, such as the COVID-19 pandemic, overload the capacity of the hospitals. Research literature has highlighted that access to trauma care is not even for all populations, especially when comparing rural and urban groups. Traditionally, the focus in trauma systems was on the designation and verification of individual hospitals as trauma centers, rather than on the overall configuration of the system. Recognition of the benefits of an inclusive trauma system has precipitated a more integrated approach. The optimal geographic configuration of trauma care centers is key to maximizing accessibility while promoting the efficient use of resources. This research reports on the development of a two-stage stochastic optimization model for geospatial expansion of a trauma network in a delimited area. The stochastic optimization model recommends the siting of new trauma care centers according to the geographic distribution of the injured population. The model has the potential to benefit both patients and institutions, by facilitating prompt access and promoting the efficient use of resources. The findings indicate that the model significantly improves trauma care coverage, particularly in rural counties, thereby enhancing equitable access to critical healthcare services.