26th International Association for Management of Technology Conference - IAMOT 2017

As populations in developing countries continue to grow, and the demand for healthcare services increase, questions frequently arise regarding the allocation of resources towards the development of new healthcare infrastructure. In order to balance resources between the tiers of the healthcare facility hierarchy\footnote{Possible facilities in the hierarchy include clinics, district/provincially aided hospitals, midwife obstetrics units, mobile services, psychiatric hospitals, regional hospitals, reproductive health facilities, specialised healthcare facilities, Tuberculosis (TB) hospitals and tertiary hospitals.} in a way that ensures optimal healthcare provision, it is paramount that decisions concerning the expansion of the healthcare service provision network should align with a clearly defined strategy. At a strategic level, it is often difficult to evaluate alternative healthcare infrastructure expansion options and to select the optimal solution (given the current healthcare system) without the use of a decision-making tool. An example of such a tool is impact assessment. In this paper, an impact assessment methodology is developed that can be used to inform the healthcare infrastructure expansion strategy of regional healthcare authorities through the holistic evaluation of the (future) impact of new healthcare infrastructure, with a specific focus on healthcare facilities. Perspectives from which the provision of a new healthcare facility are evaluated include: (i) the impact of the facility on the healthcare provision network as a whole; (ii) the impact of the facility on the total healthcare provision cost for the population that the facility serves; and (iii) the impact of the facility on healthcare outcomes amongst the population that it serves. While a multitude of impact assessment frameworks and applications are available in literature, the suite of existing impact assessment frameworks does not fit the need of the assessment required by the healthcare authorities in South Africa, as no available applications consider the specific perspectives relevant to the study. This lack of literary support confirms the need for a framework created with the specific aim of evaluating the impact of new healthcare infrastructure from the mentioned perspectives. Such a framework is thus developed through a thorough evaluation and juxtaposition of the various impact assessment frameworks and applications in literature, leading to a method suitable for the specific application. In future research, the methodology will be applied to a newly constructed district hospital to compare the relevant data metrics before and after construction. This will enable a prediction of the impact of this kind of facility on the three perspectives mentioned above. While the accuracy of the prediction may be limited initially, the methodology is constructed in a generic enough way that it will can be applied to a number of facilities in the future, leading to increased predictive capabilities.