A goal programming model for the siting of multilevel EMS systems.

Facility siting models known as location covering techniques have proven to be useful particularly for emergency medical services (EMS) planning, given the importance of ambulances responding to demand within some maximum time constraint. These models represent a set of methods which focus the health planner's attention on the access of people to health care, since they attempt to “cover” people in need of service within some specified time standard.This research develops a technique for the locational planning of sophisticated EMS systems, characterized by multiple levels of emergency health services. Specifically, a two-tiered system with “basic life support” and “advanced life support” capabilities is modeled as a goal program.By applying location covering techniques within a goal programming framework, this study develops a method for the siting of multilevel EMS systems so that (1) each service level maximizes coverage of its own demand population, and (2) “back-up” coordination between levels is assured. The usefulness of this goal program as a health planning tool is evidenced in the model's explicit articulation of EMS policy objectives and its ability to link system levels in terms of “goal-directed behavior”. The working of this multilevel covering model is demonstrated by reference to EMS planning scenarios and related numerical examples.