Centralized Versus Distributed Sterilization Service: A location-allocation Decision Model

The concept of “networking” has become central to the reform of healthcare systems. The objective is to reduce costs while improving the quality of service. This paper deals with the problem of sterilization service configuration within a hospital network. Two alternatives are considered: (1) each hospital in the network maintains its sterilization service in-house; (2) a central sterilization service ensures this function for all hospitals in the network. This decision is based on a location–allocation model of the sterilization service. A Mixed Integer Linear Program (MILP) is proposed to find the optimal configuration of the sterilization service (centralized vs. distributed), the optimal location and the optimal capacity of the centralized sterilization service over a multi-period planning horizon. The objective is to minimize costs related to transportation, production and resource acquisition and transfer.