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The aim of this paper is to propose a new location-allocation structure, in an effort to improve the operational shortcomings of the existing locations of primary health care centers. These shortcomings are mainly caused by the preference of patients to use local hospitals rather than health centers. The method is based on a biobjective mathematical programming model for locating hospitals and primary health care centers. Two objectives are considered: (1) minimization of distance between patients and facilities, (2) equitable distribution of the facilities among citizens. We formulate the model taking into consideration the interdependence of the locations i.e., the general hospitals and health centers. This approach enables us to introduce a new aspect to the location problem, namely public preferences and also to consider the decentralization of the health care system. In order to represent the available information we employ Geographic Information Systems (GIS). We apply this model in the area of Western Greece and then compare our results with the solution originally selected by planners. Demographic data concerning the major and minor population centers of the area were based on the latest census of 2001. The results confirm the necessity of applied scientific approaches for regulating the health care system in order to establish rational strategic planning and ensure the best use of the available resources.

This paper evaluates the efficiency of public hospitals with two alternative conceptual models. One model targets resource usage directly to assess production efficiency, while the other model incorporates financial results to assess economic efficiency. Performance analysis of these models was conducted in two stages. In stage one, we utilized data envelopment analysis to obtain the efficiency score of each hospital, while in stage two we took into account the influence of the operational environment on efficiency by regressing those scores on explanatory variables that concern the performance of hospital services. We applied these methods to evaluate 96 general hospitals in the Greek national health system. The results indicate that, although the average efficiency scores in both models have remained relatively stable compared to past assessments, internal changes in hospital performances do exist. This study provides a clear framework for policy implications to increase the overall efficiency of general hospitals.

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