Two-layer evolutionary optimization problem for home healthcare pathways and scheduling under multi-center resource...

Area of Science:

• Operations Research
• Healthcare Management
• Computer Science

Background:

• Multi-center home healthcare systems face challenges with imbalanced workloads and underutilized resources.
• Existing routing and scheduling methods often fail to address inter-center coordination and resource sharing effectively.

Purpose of the Study:

• To develop a bilevel optimization approach for routing and scheduling in multi-center home healthcare systems.
• To enable cross-center resource sharing to improve efficiency and reduce costs.
• To create a unified model incorporating travel time, service costs, penalties, skill-matching, and labor compliance.

Main Methods:

• Formulation of a weighted single-objective model for multi-criteria trade-offs.
• Development of the Bilevel Evolutionary Planning Framework for Multi-Center Routing and Scheduling with Resource Sharing (BEPSF).
• A hybrid GA-GAPSO strategy at the lower level for within-center routing and scheduling, including feasibility repair and elitist preservation.

Main Results:

• BEPSF significantly outperformed GA-GA and DE-DE baselines in solution quality and stability (average improvements of 31% and 63%).
• Achieved 0% deviation from the reference optimum on small-scale instances.
• Cross-center resource sharing reduced total system costs by 20-50%, with a maximum reduction of 66%.

Conclusions:

• The proposed bilevel optimization framework effectively addresses workload imbalance and resource underutilization in multi-center home healthcare.
• Cross-center resource sharing is a viable strategy for significant cost reduction and improved operational efficiency.
• Factors like working hours and time-window tolerance critically influence cost composition.