An optimization model for equitable accessibility to magnetic resonance imaging technology in developing countries

Magnetic Resonance Imaging (MRI) is a sophisticated and costly technology that provides highly accurate diagnoses of various medical conditions using a powerful magnetic field, radiofrequency pulses, and a computer to produce detailed pictures of internal body parts and organs. The dissemination of MRI use at medium and high-complexity healthcare facilities increases the cost of healthcare systems. It imposes accessibility challenges concerning the equitable availability of essential healthcare technology in developing countries. Despite the importance of this technology, very few studies approach this problem from multiple location-allocation perspectives. We propose an optimization model for equitable accessibility to MRI technology. We study this problem for the Brazilian National Health System at the municipality level, and recommend alternative locations, and acquire the new devices and technologies equitably throughout the country and health system. We show that while some municipalities have an oversupply, several regions in the country have no access to MRI technology. The models propose the number of new MRIs and their locations for needing municipalities considering equity principles. The results show, for instance, that the acquisition of 210 MRIs is enough to satisfy 95% of the demand for such service, with patients traveling 44 km on average in northern Brazil. We report accessibility gains from adopting the location-allocation plans developed using the optimization model proposed in this study.