Increasing the productivity of health facilities in urban areas in México

In Mexico, pharmacies have the possibility of offering basic health services inside or close to their facilities. The foregoing generates direct competition for non-profit civil associations such as the Mexican Red Cross in Monterrey (MRCM), which currently has nine urban health facilities, known as relief bases. As it is well known, the Red Cross is maintained through donations, and for the services provided, a voluntary fee is asked. Due to the recent financial losses, and looking for increasing the productivity of its health care facilities, the MRCM is considering the closure of some of them with a minimal social impact due to the decrease of the community's access to health services. The closure's impact of urban health facilities has not been deeply explored. After a bibliographic review, fifteen variables related to social impact were identified, which were grouped into three categories: competition, organization and affected population. Based on these variables, this paper proposes two strategies to increase the productivity of the MRCM: a staffreassignment scheme and an optimization model to determine which relief bases should be closed with the least social impact and significantly increase of the MRCM's average productivity.