HOSPITAL LOCATION PLANNING FOR ACUTE AND COMMUNITY HOSPITALS IN SINGAPORE

Abstract

A decision support tool was modelled to aid decision makers at the Ministry of Health Singapore in the planning of hospital locations through estimations of the demand that hospitals may face in the future. The model was implemented in a geographical information system software known as ArcMap. The principle of the model is based on the assumption that a patient will always visit a hospital that is closest to his/her point of residence. As such the Voronoi diagram was suitable to distribute the demand at each hospital. Any patient whose point of residence is within a particular Voronoi polygon will always visit the hospital that generated that polygon. The Voronoi diagram is subsequently modified to form Voronoi regions or areas of responsibility for each hospital. Each hospital, therefore, serves the population that is contained within their Voronoi regions. Through the application of an age-and-gender specific incidence rate, the inpatient demand at each hospital can be determined. Simulations of future hospital networks were done. In the case of acute hospitals, the opening of Ng Teng Fong General Hospital in 2014 and Sengkang General Hospital in 2018. For community hospitals, the opening of Yishun Community Hospital and Jurong Community Hospital in 2014 and the opening of Sengkang Community Hospital and Outram Community Hospital in 2018. It was found that for acute hospitals, the increase in capacity roughly kept pace with the increase in demand for the 2 time periods and this may result in an occupancy rate that is approximately unchanged throughout the years. Operationally, some hospitals may experience changes due to the shifts in inherent demand for each hospital. Some of these hospitals, such as NUH, will see a lessening of the burden on the demand for beds. For community hospitals, the capacity expansion moves faster than the increase in demand which may result in some hospitals operating sub-optimally.