Planning an Healthcare Network: the case of Clinical Laboratories in Sicily

Healthcare centers, private and public, are responsible for serving health demand of the population. Typically their respective geographical location and size is the result of a complex interaction between epidemiological, historical and economical factors. The necessity of reducing global health expenses has lead, in the last years, to a substantial redefinition of the economical parameters used to remunerate healthcare centers. This is inevitably leading to a re-organization of the laboratory network, with a possible decrease of the quality of service, especially in terms of widespread presence on the territory. The data of the laboratory analyses performed in Sicily in the year 2013 have been analyzed using inferential statistics, geo-referential and social network analysis methods. The purpose was to identify the health demand from the population and to relate it to possible new schemes of organization of the network of healthcare centers. By analyzing the available data it has been possible to associate to each center a value reflecting the amount of population served. A statistically significant difference obtained by looking at specific type of laboratory analyses has been related to factors such as physical distance from other centers, attractiveness of other centers, cost of the analysis, etc. The results obtained allowed to set the basis for planning an effective redistribution of the healthcare centers that, while preserving the demand of health from the population, could bring to an effective reduction of costs.