A decision model for allocation of funds to family planning clinics

Abstract

The purposes of this research are (1) to develop a decision model for this type of fund allocation and (2) to investigate the usefulness of linear programming as a means for the problem's formulation and solution. The goals and constraints of the constructed decision model were developed in conjunction with the Bureau.

The decision model is a mixed integer multiple objective linear program for allocation of funds to individual clinics over several time periods. The model handles both existing and proposed clinics. The continuous decision variables are the funds allocated to a given clinic in a given year. The integer decision variables are related to the opening of a proposed clinic and the closing of an established clinic.

The objective functions of the decision model constitute those family planning goals whose attainment is a predictable function of funding. To determine whether the impact of funding upon attainment of these goals is predictable, regression analyses are done using New York State data. Results show a strong relationship between funding and a clinic's patient load. However, the impact of funding upon unwanted pregnancy rates is indeterminate, due to insufficient data. Accordingly, the objective functions are (1) to maximize patients served and (2) to maximize the minimum availability of services. A third objective function, applied last, smooths uneven allocations

Incorporated into the decision model is a predictive model. The predictive model results from the regression analyses. It predicts a clinic's patient load from its fixed revenue and its previous year's patient load.

Input values needed for the decision model are the regression coefficients of the predictive model, the Target Population of each region, last year's patient load for each existing clinic, and last year's revenue for each existing clinic.

The decision model is applied to provide a three year funding plan for the Health Systems Agency of North-eastern New York.

The rate of unwanted pregnancies has been steadily increasing in the united States, particularly among teenagers. The United States Department of Health, Education, and Welfare provides annual funds for the establishment and maintenance of family planning clinics. The New York State Bureau of Family Planning is an administering agency whose task is to allocate such funds within New York State. The Bureau would like to allocate it so as to best attainfamily planning goals.