Optimal placement of Mobile Stroke Units considering the perspectives of equality and efficiency

Abstract It is widely known that the time to treatment is vital for patients who suffer from a stroke. Therefore, in different places in the world, the value of acquiring mobile stroke units has been identified. A mobile stroke unit is a specially developed ambulance for stroke treatment, which has special equipment and trained personnel who can perform intravenous stroke treatment (thrombolysis). It is clear that the involvement of mobile stroke units will aid at least a certain proportion of the stroke patients; however, mobile stroke units are often purchased and placed without any developed method or analysis of where and how it should be placed. In the current paper, we use expected value optimization in order to identify, depending on what perspective is of interest, efficiency or equality, the optimal placement of a mobile stroke unit. In an experimental study, considering the Skane County in Sweden, we show that the placement of a mobile stroke unit may vary considerably depending on which of the two perspectives is adopted.