Locating Parkinson Assessment Services to Reduce Patient Travel: A Reproducible Analysis of Average Cost, Remote Access, and Service Constraints

Abstract Travel expenditure can limit access to Parkinson assessment even when the assessment itself carries a modest charge. Service location therefore deserves evaluation alongside the price and technical performance of a test. This study develops a reproducible hypothetical location analysis that separates patient travel from diagnostic performance and total health-system cost. Twelve fictional demand locations and twelve candidate sites are connected by straight-line round-trip distances. Exhaustive enumeration identifies configurations minimizing demand-weighted mean travel, while a second objective minimizes the longest journey. A targeted narrative selection of primary access, telemedicine, economic, and geographical studies informs interpretation of the model. The fixed central-site scenario produces a mean round trip of 11.32 km. Allowing one site to relocate reduces the mean to 9.31 km but increases the longest journey from 24.33 to 32.25 km. Two freely located sites reduce the mean to 5.80 km. A two-site configuration chosen to minimize the longest journey instead has a mean of 8.82 km and a maximum of 15.62 km, illustrating a substantive trade-off between average and remote access. All locations, demand weights, and travel calculations are fictional; no real communities or patients are represented. The analysis shows why an average saving can conceal a worsening journey for a small group and why geographical optimization cannot establish earlier diagnosis, clinical equivalence, or affordability without information on transport, capacity, referral pathways, and household resources. A proposed evaluation framework reports these outcomes separately and makes the service objective explicit before implementation. 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