In-person and video-based post-traumatic stress disorder treatment for veterans: a location-allocation model.
Post-traumatic stress disorder (PTSD) is associated with poor health but there is a gap between need and receipt of care. It is useful to understand where to optimally locate in-person care and where video-based PTSD care would be most useful to minimize access to care barriers, care outside the Veterans Affairs system, and total costs. We developed a service location systems engineering model based on 2010 to 2020 projected care needs for veterans across New England to help determine where to best locate and use in-person and video-based care. This analysis determined specific locations and capacities of each type of PTSD care relative to patient home locations to help inform allocation of mental health resources. Not surprisingly Massachusetts, Connecticut, and Rhode Island are well suited for in-person care, whereas some rural areas of Maine, Vermont, and New Hampshire where in-patient services are infeasible could be better served by video-based care than external care, if the latter is even available. Results in New England alone suggest a potential $3,655,387 reduction in average annual total costs by shifting 9.73% of care to video-based treatment, with an average 12.6 miles travel distance for the remaining in-person care.
Healthcare Systems Engineering Institute, Northeastern University, 334 Snell Engineering Center, Boston, MA 02115.
Hande
H
Musdal
New England Veterans Engineering Resource Center, WRJ VAMC, 215 North Main Street, White River Junction, VT 05009.
Brian
B
Shiner
New England Veterans Engineering Resource Center, WRJ VAMC, 215 North Main Street, White River Junction, VT 05009.
Techieh
T
Chen
Lahey Clinic, Operations Management, 41 Mall Road, Burlington, MA 01805.
Mehmet E
ME
Ceyhan
New England Veterans Engineering Resource Center, WRJ VAMC, 215 North Main Street, White River Junction, VT 05009.
Bradley V
BV
Watts
Healthcare Systems Engineering Institute, Northeastern University, 334 Snell Engineering Center, Boston, MA 02115.
James
J
Benneyan
D017048:Health Care Costs; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008605:Mental Health Services; D008962:Models, Theoretical; D009511:New England; D009819:Office Visits / Q000191:economics; D018579:Patient Selection; D013313:Stress Disorders, Post-Traumatic / Q000191:economics / Q000628:therapy*; D017216:Telemedicine / Q000191:economics; D014728:Veterans / Q000523:psychology*