Reducing Overdose Deaths and Mitigating County Disparities: Optimal Allocation of Substance Use Treatment Centers

Matt Baucum (), Matt Harris (), Lawrence Kessler () and Guanyi Lu ()
Additional contact information
Matt Baucum: Department of Computer Information Systems, Colorado State University, Fort Collins, Colorado 80523
Matt Harris: Boyd Center for Business and Economic Research, University of Tennessee, Knoxville, Tennessee 37996
Lawrence Kessler: Boyd Center for Business and Economic Research, University of Tennessee, Knoxville, Tennessee 37996
Guanyi Lu: Department of Business Analytics, Information Systems, and Supply Chain, Florida State University, Tallahassee, Florida 32306

Manufacturing & Service Operations Management, 2025, vol. 27, issue 3, 736-756

Abstract: Problem definition : Substance use disorder (SUD) is a pressing health concern in the United States, and connecting communities with treatment is a growing public health imperative. We study the optimal allocation of substance use treatment centers across counties within U.S. states over a multiyear time horizon. We use a three-part objective function that minimizes (i) statewide overdose deaths, (ii) mismatch between counties’ treatment center access and overdose death rates (inequity), and (iii) mismatch between counties’ treatment center access and population (inequality). We also consider the temporal interdependence of counties’ treatment center allocations and their death-rate-based equity targets. Methodology/results : We use a predict-then-optimize approach based on data from more than 2,500 U.S. counties between 1999 and 2016. We first estimate SUD treatment centers’ causal impact on county-level overdose death rates, using mental health parity laws as an instrument. We then use these estimates in a nonlinear program that reallocates states’ observed levels of SUD treatment funding. Results suggest that this approach can meaningfully reduce statewide overdose deaths and between-county disparities in treatment access. Managerial implications : Prioritizing death rate reductions over equity/equality results in more resources being directed to high-population counties, where treatment centers are most effective. Prioritizing equity/equality in treatment access results in more resources being directed to underserved, low-population counties. We also find that states differ in their Pareto-optimal trade-offs between death rates and inequity/inequality.

Keywords: substance use; resource allocation; healthcare operations; disparities (search for similar items in EconPapers)
Date: 2025
References: Add references at CitEc
Citations:

Downloads: (external link)
http://dx.doi.org/10.1287/msom.2024.0963 (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:inm:ormsom:v:27:y:2025:i:3:p:736-756

Access Statistics for this article

More articles in Manufacturing & Service Operations Management from INFORMS Contact information at EDIRC.
Bibliographic data for series maintained by Chris Asher ().