Authors: Thirumalesha Babu T R
Abstract: This study develops a quantitative and operational framework for expanding palliative care access for older adults while enforcing equity and environmental sustainability constraints. We model palliative care benefit as B(c,q,t)=c^α q^β t^γ, where c is coverage (the share of eligible older adults reached), q is quality (clinical and psychosocial guideline fidelity), and t is timeliness (speed of symptom-responsive intervention), with exponents α,β,γ∈(0,1) capturing diminishing returns. System performance is summarized using: a composite score S=w^⊤ [c,q,t,e,x_"env " ], an equity index e based on subgroup reach (for example, rural women ≥75 living alone), a sustainability guardrail x_"env " measuring footprint per service unit, and a gap-totargets metric G=‖x^"policy " -x^"obs " ‖_2. We formulate a resource allocation problem under real constraints – clinical/volunteer capacity H/(τP), per-person budget costs k_c,k_q,k_t, and a quarterly ceiling B – and derive a practical decision rule: invest first in the lever (outreach to raise c, training/supervision to raise q, or triage redesign to raise t ) with the highest marginal impact per rupee, max{(∂B/∂c)/k_c,(∂B/∂q)/k_q,(∂B/∂t)/k_t }, unless equity or sustainability thresholds are violated. Using illustrative scenarios, we show how modest simultaneous improvements in c,q,t can raise B from approximately 0.55 to 0.63 at district scale, reduce caregiver strain, and potentially avoid costly acute-care crises. We also demonstrate portfolio comparison through a cost-effectiveness-footprint Pareto map and unmet-need heatmap for geographic staging. This work provides a replicable dashboard for gerontological systems, linking palliative care delivery to measurable benefit, budget justification, equitable reach, and low-footprint expansion, in line with calls for integrated, early, community-linked palliative care in ageing societies.
DOI: http://doi.org/10.5281/zenodo.17609179
