A heuristic approach to solve the preventive health care problem with budget and congestion constraints

This document is the Accepted Manuscript version of the following article: Soheil Davari, Kemal Kilic, and Siamak Naderi, ‘A heuristic approach to solve the preventive health care problem with budget and congestion constraints’, Applied Mathematics and Computation, Vol. 276, pp. 442-453, March 2016, doi: https://doi.org/10.1016/j.amc.2015.11.073. This manuscript version is made available under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License CC BY NC-ND 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.Preventive health care is of utmost importance to governments since they can make massive savings on health care expenditure and promote the well-being of the society. Preventive care includes many services such as cancer screenings, vaccinations, hepatitis screenings, and smoking cessation programs. Despite the benefits of these services, their uptake is not satisfactory in many countries in the world. This can be attributed to financial barriers, social issues., and other factors. One of the most important barriers for preventive care is accessibility to proper services, which is a function of various qualitative and quantitative factors such as the distance to travel, waiting time, vicinity of facilities to other attractive facilities (such as shopping malls), and even the cleanliness of the facilities. Statistics show that even a small improvement in people’s participation can save massive amounts of money for any government and improve the well-being of the people in a society. This paper addresses the problem of designing a preventive health care network considering impatient clients, and budget constraints. The objective is to maximize the accessibility of services to people. We model the problem as a mixed-integer programming problem with budget constraints, and congestion considerations. An efficient variable neighborhood search procedure is proposed and computational experiments are performed on a large set of instances.Peer reviewedFinal Accepted Versio

The Incremental Cooperative Design of Preventive Healthcare Networks

This document is the Accepted Manuscript version of the following article: Soheil Davari, 'The incremental cooperative design of preventive healthcare networks', Annals of Operations Research, first published online 27 June 2017. Under embargo. Embargo end date: 27 June 2018. The final publication is available at Springer via http://dx.doi.org/10.1007/s10479-017-2569-1.In the Preventive Healthcare Network Design Problem (PHNDP), one seeks to locate facilities in a way that the uptake of services is maximised given certain constraints such as congestion considerations. We introduce the incremental and cooperative version of the problem, IC-PHNDP for short, in which facilities are added incrementally to the network (one at a time), contributing to the service levels. We first develop a general non-linear model of this problem and then present a method to make it linear. As the problem is of a combinatorial nature, an efficient Variable Neighbourhood Search (VNS) algorithm is proposed to solve it. In order to gain insight into the problem, the computational studies were performed with randomly generated instances of different settings. Results clearly show that VNS performs well in solving IC-PHNDP with errors not more than 1.54%.Peer reviewe

Simheuristic and learnheuristic algorithms for the temporary-facility location and queuing problem during population treatment or testing events

Epidemic outbreaks, such as the one generated by the coronavirus disease, have raised the need for more efficient healthcare logistics. One of the challenges that many governments have to face in such scenarios is the deployment of temporary medical facilities across a region with the purpose of providing medical services to their citizens. This work tackles this temporary-facility location and queuing problem with the goals of minimizing costs, the expected completion time, population travel and waiting times. The completion time for a facility depends on the numbers assigned to those facilities as well as stochastic arrival times. This work proposes a learnheuristic algorithm to solve the facility location and population assignment problem. Firstly a machine learning algorithm is trained using data from a queuing model (simulation module). The learnheuristic then constructs solutions using the machine learning algorithm to rapidly evaluate decisions in terms of facility completion and population waiting times. The efficiency and quality of the algorithm is demonstrated by comparison with exact and simulation-only (simheuristic) methodologies. A series of experiments are performed which explore the trade offs between solution cost, completion time, population travel and waiting times.Peer ReviewedPostprint (author's final draft

The Elderly Centre Location Problem

© The Operational Research Society 2020. This is an Accepted Manuscript of an article published by Taylor & Francis in Journal of the Operational Research Society on 12 Feb 2020, available online: https://doi.org/10.1080/01605682.2020.1718020.Increased human life expectancy combined with declining birth rates around the globe has led to ageing populations, particularly in the developed world. This phenomenon brings about increased dependency ratios and calls for setting new policies for the elderly citizens. This comprises the provision of a set of life-enhancing services in an accessible and equitable way. In this paper, we consider a multi-period problem of locating senior centres offering these services to the elderly population against budget constraints and capacity limitations. We assume that the attractiveness of facilities to elderlies is inversely proportional with the travel time to access these facilities. Both consistent and inconsistent versions of the problem are considered, aiming at identifying the set of facilities to operate in each region at each period, the service type(s) to be offered and the allocation of budget in each period to location and operation of facilities. A mixed integer mathematical programming model is presented, an efficient iterated local search procedure is proposed and managerial insights are provided.Peer reviewedFinal Accepted Versio

SOLVING FIRE DEPARTMENT STATION LOCATION PROBLEM USING MODIFIED BINARY GENETIC ALGORITHM: A CASE STUDY OF SAMSUN IN TURKEY

Fire and traffic accident are the most common problem in our daily lives. Fire department location for the purpose of easy response and recovery is a significant problem today. The best location of a fire department station determines the rate of recovery of many injured people after traffic accident, fire outbreak, and so on. In this paper, we considered the best location of fire stations. In addition, we also considered where the station is setup. Surveying problem is modeled as a mixed integer programming. It is solved by modified binary genetic algorithm, coding with GAMS. Modified binary GA is different from known GA with respect to binary decision variables. Due to this problem, initial value of the objective function was obtained from known GA. Then finally, the best result was achieved from binary GA

SOLVING FIRE DEPARTMENT STATION LOCATION PROBLEM USING MODIFIED BINARY GENETIC ALGORITHM: A CASE STUDY OF SAMSUN IN TURKEY

Fire and traffic accident are the most common problem in our daily lives. Fire department location for the purpose of easy response and recovery is a significant problem today. The best location of a fire department station determines the rate of recovery of many injured people after traffic accident, fire outbreak, and so on. In this paper, we considered the best location of fire stations. In addition, we also considered where the station is setup. Surveying problem is modeled as a mixed integer programming. It is solved by modified binary genetic algorithm, coding with GAMS. Modified binary GA is different from known GA with respect to binary decision variables. Due to this problem, initial value of the objective function was obtained from known GA. Then finally, the best result was achieved from binary GA

Assessing performance in health care: A mathematical programming approach for the re-design of primary health care networks

Mathematical models allow studying complex systems. In particular, optimal facility location models provide a sound framework to assess the performance of first-level of health care networks. In this work, a methodology founded on need/offer/demand quantification through a facility location-based mathematical model is proposed to assess the performance of existing networks of Primary Health Care Centers (PHCC) and assist in its re-design. The proposed re-design problem investigates the re-allocation of existing resources within the given infrastructure (existing PHCCs) to better satisfy the estimated health needs of the target population. This problem has not been widely addressed in the open literature despite its paramount importance in modern societies with fast demographic dynamics and constrained investment capacities. The model seeks to optimally assign the required type of service and the corresponding capacity to each PHCC (offer). The objective function to be maximized is the number of (needed) patients’ visits effectively covered by the network (demand). The following constraints are explicitly considered: i) geographic accessibility from need centers to PHCCs, ii) maximum delivery capacity of each service in each PHCC, and iii) total budget regarding fixed, variable, and relocation costs. The proposed methodology was applied to a medium-size city. Results show that the non-attended necessity can be reduced by introducing capacity modifications in the existing network. Moreover, different solutions are obtained if budgetary restrictions or minimum attention volume constraints are included. This reveals how model-based decision support tools can help health decision-makers assessing primary health care network performance.Fil: Elorza, Maria Eugenia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Económicas y Sociales del Sur. Universidad Nacional del Sur. Departamento de Economía. Instituto de Investigaciones Económicas y Sociales del Sur; ArgentinaFil: Moscoso, Nebel Silvana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Económicas y Sociales del Sur. Universidad Nacional del Sur. Departamento de Economía. Instituto de Investigaciones Económicas y Sociales del Sur; ArgentinaFil: Blanco, Anibal Manuel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Planta Piloto de Ingeniería Química. Universidad Nacional del Sur. Planta Piloto de Ingeniería Química; Argentin

Modelling and solving healthcare decision making problems under uncertainty

The efficient management of healthcare services is a great challenge for healthcare managers because of ageing populations, rising healthcare costs, and complex operation and service delivery systems. The challenge is intensified due to the fact that healthcare systems involve various uncertainties. Operations Research (OR) can be used to model and solve several healthcare decision making problems at strategic, tactical and also operational levels. Among different stages of healthcare decision making, resoure allocation and capacity planning play an important role for the overall performance of the complex systems. This thesis aims to develop modelling and solution tools to support healthcare decision making process within dynamic and stochastic systems. In particular, we are concerned with stochastic optimization problems, namely i) capacity planning in a stem-cell donation network, ii) resource allocation in a healthcare outsourcing network and iii) real-time surgery planning. The patient waiting times and operational costs are considered as the main performance indicators in these healthcare settings. The uncertainties arising in patient arrivals and service durations are integrated into the decision making as the most significant factors affecting the overall performance of the underlying healthcare systems. We use stochastic programming, a collection of OR tools for decision-making under uncertainty, to obtain robust solutions against these uncertainties. Due to complexities of the underlying stochastic optimization models such as large real-life problem instances and non-convexity, these models cannot be solved efficiently by exact methods within reasonable computation time. Thus, we employ approximate solution approaches to obtain feasible decisions close to the optimum. The computational experiments are designed to illustrate the performance of the proposed approximate methods. Moreover, we analyze the numerical results to provide some managerial insights to aid the decision-making processes. The numerical results show the benefits of integrating the uncertainty into decision making process and the impact of various factors in the overall performance of the healthcare systems

Essays On Stochastic Programming In Service Operations Management

Deterministic mathematical modeling is a branch of optimization that deals with decision making in real-world problems. While deterministic models assume that data and parameters are known, these numbers are often unknown in the real world applications.The presence of uncertainty in decision making can make the optimal solution of a deterministic model infeasible or sub-optimal. On the other hand, stochastic programming approach assumes that parameters and coefficients are unknown and only their probability distribution can be estimated. Although stochastic programming could include uncertainties in objective function and/or constraints, we only study problems that the goal of stochastic programming is to maximize (minimize) the expectation of the objective function of random variables. Stochastic programming has a wide range of application in manufacturing production planning, machine scheduling, dairy farm expansion planning, asset liability management, traffic management, and automobile dealership inventory management that involve uncertainty in decision making. One limitation of stochastic programming is that considering uncertainty in mathematical modeling often leads to a large-scale programming problem. The most widely used stochastic programming model is two-stage stochastic programming. In this model, first-stage decision variables are determined before observing the realization of uncertainties and second-stage decision variables are selected after exposing first-stage variables into the uncertainties. The goal is to determine the value of first-stage decisions in a way to maximize (minimize) the expected value of second-stage objective function. 1.1 Motivation for Designing Community-Aware Charging Network for Electric Vehicles Electric vehicles (EVs) are attracting more and more attentions these days due to increase concern about global warming and future shortage of fossil fuels. These vehicles have potential to reduce greenhouse gas emissions, improve public health condition by reducing air pollution and improving sustainability, and addressing diversication of transportation energy feedstock. Governments and policy makers have proposed two types of policy incentives in order to encourage consumers to buy an EV: direct incentives and indirect incentives. Direct incentives are those that have direct monetary value to consumers and include purchase subsidies, license tax/fee reductions, Electric Vehicle Supply Equipment (EVSE) financing, free electricity, free parking and emission test exemptions. On the other hand, indirect incentives are the ones that do not have direct monetary value and consist of high-occupancy vehicle access, emissions testing exemption time savings, and public charger availability. Lack of access to public charging network is considered to be a major barrier in adoption of EVs [38]. Access to public charging infrastructure will provide confidence for EV owners to drive longer distances without going out of charge and encourage EV ownership in the community. The current challenge for policy makers and city planners in installing public charging infrastructure is determining the location of these charging service stations, number of required stations and level of charging since the technology is still in its infancy and the installation cost is high. Since recharging of EV battery takes more time than refueling conventional vehicles, parking lots and garages are considered as potential locations for installing charging stations. The aim of this research is to develop a mathematical programming model to find the optimal locations with potentially high utilization rate for installing community-aware public EV charging infrastructure in order to improve accessibility to charging service and community livability metrics. In designing such charging network, uncertainties such as EV market share, state of battery charge at the time of arrival, driver’s willingness to charge EV away from home, arrival time to final destination, driver’s activity duration (parking duration), and driver’s walking distance preference play major role. Incorporating these uncertainties in the model, we propose a two-stage stochastic programming approach to determine the location and capacity of public EV charging network in a community. 1.2 Motivation for Managing Access to Care at Primary Care Clinics Patient access to care along with healthcare efficiency and quality of service are dimensions of health system performance measurement [1]. Improving access to primary care is a major step of having a high-performing health care system. However, many patients are struggling to get an in-time appointment with their own primary care provider (PCP). Even two years aer health insurance coverage was expanded, new patients have to wait 82% longer to get an internal-medicine appointment. A national survey shows that percentage of patients that need urgent care and could not get an appointment increased from 53% to 57% between 2006 and 2011 [30]. This delay may negatively impact health status of patients and may even lead to death. Patients that cannot get an appointment with their PCP may seek care with other providers or in emergency departments which will decrease continuity of care and increase total cost of health system. The main issue behind access problem is the imbalance between provider capacity and patient demand. While provider panel size is already large, the shortage in primary care providers and increasing number of patients mean that providers have to increase their panel size and serve more patients which will potentially lead to lower access to primary care. The ratio of adult primary care providers to population is expected to drop by 9% between 2005 and 2020 [12]. Moreover, patient flow analysis can increase efficiency of healthcare system and quality of health service by increasing patient and provider satisfaction through better resource allocation and utilization [39]. Effective resource allocation will smooth patient ow and reduce waste which will in turn results in better access to care. One way to control patient flow in clinic is managing appointment supply through appointment scheduling system. A well-designed appointment scheduling system can decrease appointment delay and waiting time in clinic for patients and idle time and/or overtime for physicians at the same time and increase their satisfaction. Appointment scheduling requires to make a balance between patient needs and facility resources [13]. The purpose of this study is to gain a better understanding for managing access to care in primary care outpatient clinics through operations management research. As a result of this under standing, we develop appointment scheduling models using two-stage stochastic programming to improve access while maintaining high levels of provider capacity utilization and improving patient flow in clinic by leveraging uncertainties in patient demand, patient no-show and provider service time variability

Planning and Scheduling Optimization

Although planning and scheduling optimization have been explored in the literature for many years now, it still remains a hot topic in the current scientific research. The changing market trends, globalization, technical and technological progress, and sustainability considerations make it necessary to deal with new optimization challenges in modern manufacturing, engineering, and healthcare systems. This book provides an overview of the recent advances in different areas connected with operations research models and other applications of intelligent computing techniques used for planning and scheduling optimization. The wide range of theoretical and practical research findings reported in this book confirms that the planning and scheduling problem is a complex issue that is present in different industrial sectors and organizations and opens promising and dynamic perspectives of research and development