ABSTRACT If scarce resources are not used efficiently, welfare could be increased without any cost. Efficiency metrics have a long tradition in economics. However, measures of spatial efficiency (SE) are far less common in the literature. In health care, SE is crucial to guarantee population’s access to health care providers. We develop a metric of SE of Primary Health Care Centres (PHCCs) location based on the comparison of the minimum distances users must travel to reach a PHCC, considering their current location, against the distances they should travel if all PHCCs were optimally located. We apply this metric to assess the spatial efficiency of the PHCCs of Bahía Blanca City (Argentina). To determine the optimal location of the centres we used a capacitated P-Median model. The annual demand for medical consultations of each demand node was estimated by adjusting the number of inhabitants of that node by a socioeconomic index.

Resumen Los administradores de los sistemas de salud constantemente deben tomar decisiones referidas a su diseño y planificación, su gestión, y la evaluación de sus operaciones, entre otras. En este contexto, es necesario contar con una visión integral de los problemas, lo cual se puede lograr a partir de la conjunción de los métodos e instrumentos de la Economía de la Salud con la Ingeniería de Sistemas. El objetivo de este trabajo es reflexionar sobre las posibilidades de lograr mejoras en los sistemas de salud a partir del desarrollo del trabajo interdisciplinario entre dichas ciencias. Para ello, se exponen los objetivos de la Economía de la Salud y la Ingeniería de Sistemas de Procesos como disciplinas científicas, y se revisan algunas aplicaciones de este enfoque, que permite el diseño de herramientas para asistir en la toma de decisiones referidas a la asignación de los recursos en el sector salud. Se concluye que el modelamiento matemático, propio de la ingeniería puede ser utilizado para asesorar a los tomadores de decisiones, proporcionando información útil sobre las estrategias óptimas, teniendo en cuenta las restricciones de carácter político, presupuestarias, técnicas y de equidad propuestas por los economistas de la salud. JEL: A12; I10; I19; C02.

Abstract Health system administrators must constantly make decisions regarding its design and planning, its management, and the evaluation of its operations, among others. In this context, it is necessary to have a comprehensive vision of the problems faced by health systems, which can be achieved by combining the methods and tools provided by Health Economics and Systems Engineering. The aim of this work is to reflect on the possibilities of achieving improvements in health systems from the development of interdisciplinary work between these sciences. For this, the objectives of Health Economics and Process Systems Engineering as scientific disciplines are presented, and some applications of this approach, which allow the design of tools that collaborate in assisting decision-making for the allocation of resources in the health sector, are reviewed. It is concluded that engineering mathematical modeling can be used to advise decision makers, providing useful information on optimal strategies, taking into account the political, budgetary, technical and equity restrictions proposed by health economists. JEL: A12; I10; I19; C02.