The Government of Korea has established national objectives to set up a well organized´ welfare system during the Fifth and Sixth Five Year Development Plan (1982--1991) as well as the economic development.
Health care is the main component of social security program as is in other´ country. Health care system of Korea, however, has many problems to be solved to fulfill the expectation of the people. First of all, we have to take measures to meet the expected increase of medical utilization, which is and will be induced by the rapidly expanding medical insurance scheme. The coverage rate of medical insurance and medical assistance scheme is planned to be 9576 in 1988. It is inevitable that enormous increase of medical care will follow, while the provision of hospital beds is only 1.2 per thousand of population in 1982.
Provision of health resources appropriate to meet the need is naturally understood´, as the key for the successful operation of the Korean health care system. Among the health resources, hospital is the core in health care system. However, in Korea, the problems of the hospitals are not only the shortage: of beds, but also the lack of functional division among the hospitals, unbalanced geographical distribution, and the lack of standardization.
In this background, this research project is to design a hospital allocation program to maximize the effectiveness and efficiency of resources provision, and the availability and accessibility for the patients. The researchers have developed a mathematical model for optimal hospital allocation by service areas and by year, and selection of optimal location. Allocation should be based on forecasted demand of medical care, which is one part of this project. Planning horizon is from 1981 to. 1991, but parameters was forecasted beyond the year of 1991.
Several adjunct topics are included in the project. They are themselves very important for the national health care system. One of them is the reshuffle of health care delivery system, which is up to the present very unorganized. Another is the set-up of catchments areas, which has not existed in Korea. Third one is the development of standard modules of hospital. Other minor topics will be investigated. Korea Hospital Facility Allocation Model (KOHFAM) is the mathematical model developed in this study, it has the characteristics as follows.
1. The input variables can be up-dated, whenever necessary. Y 2. The input variables are selected only if they are available in Korea. 3. Modernization and expansion of existing hospitals have priority to the new hospital establishment. 4. Input and output variables of KOHFAM can be incorporated with the other fields of health care
system.
Tertiary hospital beds are allocated heuristically according to the forecasted demand of medical care by the "region". For the allocation of the secondary hospital beds,. an objective function was developed. It is aiming at the minimization of shortage of beds and maximization of spatial accessibility under the constraints of number of expansion and investment cost. The algorithm is as follows.
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