Due to the lack of efficiency, fragmentation and commoditization of healthcare in Latin America, the Ministry of Health in Chile has promoted the establishment of Integrated Health Services Networks, following the recommendations of the Pan American Health Organization. It aims to change the management focus of health resources, through the integration and coordination between hospitals in a health network. However, it has been proven unsuccessful since there still exists poor spatial accessibility to the healthcare system in rural areas of Chile. Its population faces long access times for specialized health services, which are concentrated in the regional capitals, and is often transferred to hospitals far away from their homes to receive treatment. The present study proposes the establishment of a collaborative economy for a successful implementation of Integrated Health Services Networks, through a Collaborative Health Resources Management Model, based on the practice of sharing hospital resources between medical centers, allowing daily transfers of doctors and medical equipment within a hospital network. The objective is to meet local demand and increase rural accessibility to healthcare, in terms of reducing patient transfers between hospitals and access times. To compare the current and proposed scenarios, an Integer Optimization Model with a network structure is formulated. The case study is focused on urology specialty in Zona del Reloncaví, a rural area located in southern Chile. Several numerical experiments are carried out for a health network composed by the three main medical centers in the area, for which their daily demand of a month is simulated based on historical information. It is concluded that the mobility of hospital resources, specifically doctors and equipment, is optimal, given that the average number of patient transfers is reduced by approximately 95.6% and the average access time is reduced by 83%. In parallel, the value of investments in medical equipment purchased by the State is maximized, which allows hospitals to improve their level of service and meet patients’ needs, regardless of their location. By doing so, hospitals in an Integrated Health Services Networks are able to stretch their limited capital budgets by jointly purchasing equipment, providing network-wide access to resources needed for expanding healthcare accessibility. Moreover, the scalability of this work lies in its extension to different specialties and healthcare situations, such as the COVID-19 Vaccination Plan.

Keywords

Healthcare, Logistics, Accessibility, and Collaborative economy.