Perinatal assistance network planning via simulation

Consider a geographical region where population is distributed in health districts, and there exists a neonatal care network, which includes birth centres able to supply assistance at three levels, respectively basic assistance, mild pathology care and intensive care. Each mother-to-be is admitted to a facility where the assistance level corresponds to the expected newborn conditions; newborn transfers from a lower to a higher-level facility are affected if conditions worsen. Each district has a known probabilistic demand for each care level previously mentioned and each facility is characterized by its capacity, i.e., the amount of patients simultaneously admittable there. A simulation model describing mothers and newborns movements from districts to birth centres and among centres has been built up, with the aim of revealing inadequacies of the assistance network and of obtaining useful suggestions about network resizing to improve service quality and reduce trouble due to distance. The model has been applied to Veneto region in North-East Italy but its use may be extended to other similar situations.