Fuzzy Bi-Objective Preventive Health Care Network Design

Preventive health care is unlike healthcare for acute ailments, as people are less alert to their unknown medical problems. In order to motivate public and to attain desired participation levels for preventive programs, the attractiveness of the health care facility is a majör concern. Health economics literatüre indicates that attractiveness to a facility is significantly influenced by proximity of the clients to it. Hence attractiveness is generally modelledasa function of distance. However, abundan tempirical evidence suggests that other qualitative factors such as perceived quality, attractions nearby, amenities, etc. also influence attractiveness. Therefore,are alistic measures houldin corporate the vagueness in the concept of attractiveness to the model. The public policy makers should also maintain the equity among various neighborhoods, which should be considered as a second objective. Finally, even though general tendency in the literatüre is to focus on health benefits, the cost effectiveness is still a factor that should be considered. In this paper, a fuzzybi-objective model with budget constraints of the problem is developed. Later, by modelling the attractiveness by means of fuzzy triangular numbers and treating the budget constraint as a soft constraint, a modified and more realistic version of the model is introduced. Two solution methodologies, namely fuzzy goal programming and fuzzy chance constrained optimization are proposed as solutions. Both the original and the modified models are solved within the framework of a casestudy in Istanbul, Turkey. In the case study, the Microsoft Bing Mapisutilized in order to determine more accurate distance measures among the nodes