Dynamic Scheduling of Home Health Care Patients to Medical Providers

40 Pages Posted: 30 Jul 2018

See all articles by Andre Augusto Cire

Andre Augusto Cire

University of Toronto at Scarborough - Division of Management; University of Toronto - Operations Management

Adam Diamant

York University - Schulich School of Business

Date Written: July 8, 2018

Abstract

Home care provides personalized medical care and social support to patients within their own home. Our work proposes a dynamic scheduling framework to assist in the assignment of patients to health practitioners (HPs) at a single home care agency. We model the decision of which patients to assign to HPs as a discrete-time Markov decision process. Due to the curse of dimensionality and the difficult combinatorial structure associated with an HP's daily travel, we propose an approximate dynamic programming approach (ADP). Our method is based on a one-step policy improvement heuristic and includes both predictive and prescriptive components. In particular, the ADP policy is formulated as a stochastic program that estimates future HP assignments using patient features, such as the type of treatment that is required and the region of residence. We show how to obtain these estimates using supervised learning techniques or by solving a mathematical program. We then solve the stochastic program using a novel adaption of the integer L-shaped algorithm and present valid inequalities to speed up convergence. We investigate several extensions to account for multiple patient-HP assignments, patients who return for service, and periodic care. Our solution methodology is compared to existing policies in a discrete-event simulation using data from a Canadian home care provider.

Suggested Citation

Cire, Andre Augusto and Diamant, Adam, Dynamic Scheduling of Home Health Care Patients to Medical Providers (July 8, 2018). Available at SSRN: https://ssrn.com/abstract=3210339 or http://dx.doi.org/10.2139/ssrn.3210339

Andre Augusto Cire (Contact Author)

University of Toronto at Scarborough - Division of Management ( email )

1265 Military Trial
Scarborough, Ontario M1C 1A4
Canada

University of Toronto - Operations Management ( email )

105 St. George st
Toronto, ON M5S 3E6
Canada

Adam Diamant

York University - Schulich School of Business ( email )

4700 Keele Street
Toronto, Ontario M3J 1P3
Canada

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