Hierarchical Planning Models for Public Healthcare Supply Chains

Public Healthcare Services

Health is an indicator of an individual’s quality of life, and access to healthcare services is one of the fundamental rights of human beings (WHO, 2017). With the advancement in technology, healthcare services have become quite specialized and the cost of healthcare has increased to unaffordable levels. The provision of quality and sustainable healthcare services is a huge challenge for organizations and governments, especially in the developing countries. Public healthcare comprises of complex chain of community workforce, with primary, secondary and tertiary level healthcare facilities to provide preventive, curative and specialized healthcare service delivery (Min, 2014). This service delivery chain or healthcare supply chain is supported by a network of government, semi-government and private organizations. The main objective of every healthcare system, particularly public healthcare system is the provision of best quality healthcare services to the patients at an affordable cost. To achieve this, healthcare organizations have to plan purposefully and to use their available resources efficiently while ensuring that healthcare services are accessible to all (Min, 2014). Public healthcare systems are organized in a tiered manner so that healthcare services reach across the population and that they are effectively managed.

(Source: Min, 2014)

Community workforce, largely comprising of vaccinators and community mobilizers, are the first contact point, for healthy and unhealthy population alike, on basic healthcare issues (vaccination, safe delivery and pregnancy, etc.). However, in absence of robust community workforce, primary healthcare centers are typically first medical center for most people. Primary centers are generally provided with general practitioners. The aim of primary center is to provide easily accessible route to healthcare dealing with broad range of common illnesses, preventive care, physical and social problems, rather than specialists in any particular disease area (Center for Academic Primary Care, 2017).

Secondary healthcare centers serve as first referral point from primary centers. These centers have general practitioners and specialized consultants in some common areas of healthcare and basic level of diagnostic support. Health care services at this level include acute care, short period stay in hospital emergency or indoor department for brief but serious illness or trauma (Min, 2014). The third tier in this network, Tertiary healthcare centers, offer specialized consultative care, and are equipped with advanced diagnostic support services. Healthcare at tertiary level is provided usually on referral from primary and secondary health care centers. These different types of healthcare services combine together to form healthcare supply chain as shown in Table 1.

A hierarchical relationship exists between different tiers of public healthcare system in terms of the patient load and the level of healthcare facilities each tier offers. Primary healthcare facilities lie at the lowest end of the hierarchy followed by secondary and tertiary healthcare services. Quality of healthcare at these tiered service centers is ensured through a network of teaching institutes; drug and equipment manufacturers, retailers, and regulatory agencies; medical practices; regulating and monitoring bodies; international donors and technical partners; government health department and other organizations forming a complete healthcare supply chain.