Optimal Resource Allocation in Community Hypertension Programs

This paper presents a simple model to guide the efficient allocation of resources in community programs to detect and treat hypertension. We model such programs as n-component series systems, where each stage must function in sequence in order for the system as a whole to operate. The model differs from standard series reliability models in that, if a component fails, costs at subsequent stages are not incurred. This "pay-as-you-go" aspect implies that widespread screening is inefficient, and that resources could be better spent ensuring continued treatment of identified hypertensives. Calculations based on actual programs suggest that an optimal allocation of a fixed budget could increase significantly the number of hypertensives controlled, by about 40 percent in our example. This conclusion is robust under all but the most pessimistic assumptions.