Health care supply chain design: Toward linking the development and delivery of care globally

This article is motivated by the gap between the growing demand and available supply of high-quality, cost-effective, and timely health care, a problem faced not only by developing and underdeveloped countries but also by developed countries. The significance of this problem is heightened when the economy is in recession. In an attempt to address the problem, in this article, first, we conceptualize care as a bundle of goods, services, and experiences - including diet and exercise, drugs, devices, invasive procedures, new biologics, travel and lodging, and payment and reimbursement. We then adopt a macro, end-to-end, supply chain-centric view of the health care sector to link the development of care with the delivery of care. This macro, supply chain-centric view sheds light on the interdependencies between key industries from the upstream to the downstream of the health care supply chain. We propose a framework, the 3A-framework, that is founded on three constructs - affordability, access, and awareness - to inform the design of supply chain for the health care sector. We present an illustrative example of the framework toward designing the supply chain for implantable device-based care for cardiovascular diseases in developing countries. Specifically, the framework provides a lens for identifying an integrated system of continuous improvement and innovation initiatives relevant to bridging the gap between the demand and supply for high-quality, cost-effective, and timely care. Finally, we delineate directions of future research that are anchored in and follow from the developments documented in the article.