linear
I. INTRODUCTION
OME health care is a service that medical institutions
provide to patients who, due to their health conditions,
can be treated in their homes, in other cases it's an strategy to
increasing the capacity of rooms in hospitals. Taking into
account the availability of qualified personnel (doctors, nurses,
and therapists), the health sector companies offer a variety of
treatments required by patients in which time, cost and quality
of the service are crucial; therefore personnel scheduling and
the routing of visits has great importance.
The optimization of home health care has long been a field
of interest for the operations research, in this context the
ISBN: 978-1-61804-256-9
iV j V p P d D sS
s
p
SP
TM
d
i
lid
M
N
KM i
KEi
KTi
Yi pd
Ui
X jipd , i PM , p P, d D
j PM
X ijpd 0, i V , p P, d D
(5)
(6)
X ijpd 1, i V / PM , p P, d D
(7)
X ijpd 1, j V / PM , p P , d D
(8)
j PM
i PM
X ijpd 0, i V , d D
j V / PM , j p pP , p j
d KM i
j V , j i pM
(9)
X ijpf 1, i PM , d H KM i
(10)
X ijpf 1, i PM , d H KEi
(11)
X ijpf 1, i PM , d H KTi
(12)
f d
d KEi
j V , j i p E
f d
d KTi
j V , j i pT
f d
pd
ij
SPps DM is , i PM , s S
(13)
pd
ij
SPps DEis , i PM , s S
(14)
pd
ij
SPps DTi s , i PM , s S
(15)
pd
ij
1, i PM , d D
(16)
pd
ij
1, i PM , d D
(17)
pd
ij
1, i PM , d D
(18)
jV d D pM
jV d D p E
jV d D pT
j V pM
jV p E
jV pT
U i U j X ijpd N N 1, i , j PM , p P , d D
(19)
X ijpd 0,1 , i, j V , i j , p P, d D
(20)
Yi pd 0, i V , p P, d D
(21)
U i 0, i V
(22)
X ijpd
j V , j i
Decision variables
X ijpd
(4)
Parameters
DTi s
(2)
(3)
j PM
DEis
(1)
eid Yi pd lid , i PM , p P, d D
sS
DM is
ps
TSi TM , i V , p P , d D
s
pd
ij
jV
TSips
Subject to
TVijp
142
and (4) impose the time window per each patient each day
according to the staff. Constraints (5) ensures the flow of staff
patients every day. Constraints (6) avoid fictitious routes of the
staff. Constraints (7), (8) and (9) determine the medical staff
every day goes out and returns to their respective home.
Constraints (10), (11) and (12) determine the period of time
between visits to each patient according to the type of staff and
planning horizon. Constraints (13), (14) and (15) guarantee the
fulfillment of the demand for visits of each patient according
to the type of staff required. Constraints (16), (17) and (18)
impose maximum one service with every visit to medical
personnel for each patient per day. Constraints (19) eliminates
the subtours generated in the programming model. Finally,
constraint (20) define the variable X ijpd and constraints (21)
Number of
specialists
3
8
8
Type of staff
Doctors
Nurses
Therapists
V. RESULTS
As mentioned in section II the model proposed in this article
is complex, and is based on a Multi-Traveling Salesman
Problem with Time Windows, Multi-Depot and Multi-Period
(MTSPTWMDMP). For HHCRSP model validation tests with
Total
Type of service
1
2
3
4
0
1
1
1
1
1
1
1
0
0
1
1
19
Table III Type of service, demand and periodicity of visits required by patients
Type of service
Patient i
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
1
1
1
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
1
1
1
1
KEi
KTi
DM is
DEis
DTi s
3
4
4
3
5
4
4
3
3
4
2
4
2
3
1
2
1
3
2
1
2
2
1
1
2
3
1
3
1
3
4
2
1
1
2
2
2
3
2
2
2
1
2
1
1
2
2
1
2
1
2
2
2
3
1
3
2
3
3
3
2
3
3
3
3
3
3
3
2
3
2
3
2
2
3
2
2
3
3
2
2
3
3
3
2
2
Total
25
44
32
Demand of visits
respective order, and finally part of the last patient (13) to her
home as the end point of the route.
The model gives total of 27 routes divided into 11 days
(Appendix: Results of the Model of the HHCRSP), routes are
carried out by a total of 12 staff members (doctor 1, doctor 2,
doctor 3, nurse 2, nurse 6, nurse 8, therapist 1, therapist 3,
therapist 4, therapist 5, therapist 6 and therapist 7), as the total
number of staff members mentioned above are 19, therefore
compliance is evidence with the route with 7 members less,
proving the optimization of human resources and the capacity
to serve a greater number of patients.
143
Day 1
Nurse 8
From
To
NH8
11
11
15
15
3
3
2
2
NH8
Doctor 3
From To
DH3
10
10
6
6
15
15
13
13
12
12
DH3
Therapist 5
From
To
TH5
4
4
13
13
12
12
TH5
The total operation time of the staff in all the time horizon is
8346 minutes, for which the 64.1% of the time corresponds to
the time of travel, and the remaining 35.9% of time
corresponds to the time of service.
Day 4
Nurse 2
Therapist 4 Therapist 6
From To From To From To
NH2
10
TH4
8
TH6
16
10
6
8
9
16
14
6
9
9
13
14
15
9
15
13
12
15
TH6
15
1
12
TH4
1
NH2
Day 5
Doctor 1
Nurse 8
From To From To
DH1
11
NH8
11
11
8
11
5
8
16
5
8
16
7
8
7
7
DH1
7
13
13
12
12
NH8
I. CONCLUSION
This article proposes a model for the problem of routing and
scheduling of medical staff in the home health care systems,
which considers characteristics as different types of staff,
different services, multi-depot, time windows and multiperiod. These features facilitates the application of this model
in real conditions related with the home health care services.
The study of the HHCRSP can lead in many directions. First
implement heuristics and metaheuristics, which allow the
analysis of the problem with more data in less time. On the
other hand the integration of other types of services as delivery
and pick-up of medicines and biological samples and the
emergency services, which involve new constraints and
considerations associated with uncertainty in the demand and
the availability of staff.
Day 6
Nurse 2
From To
NH2
10
10
9
9
16
16
14
14
4
4
NH2
Day 7
Doctor 1
Therapist 1 Therapist 5 Therapist 7
From To From To From To From To
DH1
5
TH1
7
TH5
11
TH7
10
5
3
7
TH1
11
14
10
6
3
13
14
13
6
5
13
DH1
13
12
5
8
12
TH5
8
9
9
TH7
Day 1
Nurse 6
Nurse 8
Therapist 5
From To From To From To
NH6
6
NH8
11
TH5
4
6
5
11
15
4
13
5
8
15
3
13
12
8
13
3
2
12
TH5
13
NH6
2
NH8
Day 8
Doctor 1
Nurse 2
From To From To
DH1
10
NH2
7
10
9
7
3
9
DH1
3
2
2
1
1
NH2
Day 3
Therapist 3
From To
TH3
5
5
TH3
ISBN: 978-1-61804-256-9
144
[4]
Day 9
Doctor 3
From To
DH3
11
11
6
6
15
15
DH3
[5]
[6]
[7]
Day 10
Nurse 2
Therapist 6 Therapist 7
From To From To From To
NH2
10
TH6
8
TH7
10
10
6
8
7
10
6
6
9
7
TH6
6
9
9
15
9
15
15
1
15
TH7
1
NH2
[8]
[9]
[10]
[11]
Day 11
Nurse 8
Therapist 6
From To From To
NH8
3
TH6
11
3
2
11
5
2
NH8
5
16
16
14
14
4
4
TH6
[12]
[13]
[14]
[15]
[16]
Day 12
Doctor 1
Doctor 2
Nurse 2
Nurse 8
From To From To From To From To
DH1
5
DH2
4
NH2
16
NH8
11
5
8
4
12
16
14
11
5
8
16
12
DH2
14
4
5
8
16
14
4
NH2
8
7
14
15
7
13
15
13
13
12
13
DH1
12
NH8
[17]
[18]
[19]
[20]
ACKNOWLEDGMENT
The authors thank the sponsorship of this project to the
Master in Operations Management and the International
School of Economics and Management Sciences (EICEA) of
the Universidad de La Sabana.
REFERENCES
[1]
[2]
[3]
ISBN: 978-1-61804-256-9
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