An iterative switching heuristic to locate hospitals and helicopters

The Trauma Resource Allocation Model for Ambulances and Hospitals (TRAMAH) was created to guide health planners in locating important and expensive resources. The model’s solution algorithm combines a mixed-integer linear program and a new ‘‘iterative switching’’ heuristic. The TRAMAH has the computational flexibility to optimally locate various numbers of aeromedical depots and trauma centers as separate resources or in tandem. It can be engineered to build a regional trauma system from ‘‘clean slate’’ or to accommodate well-developed trauma systems that are only seeking incremental changes. In this first application of TRAMAH using the Maryland Trauma System, the ‘‘iterative switching’’ heuristic allowed us to obtain solutions within reasonable computer processing times. The TRAMAH can thus help trauma systems improve the survival rates of their most severely injured patients. # 2001 Published by Elsevier Science Ltd.