Multi-objective optimization in partitioning the healthcare system of Parana State in Brazil

Motivated by a proposal of the local authority for improving the existing healthcare system in the Parana State in Brazil, this article presents an optimization-based model for developing a better system for patients by aggregating various health services offered in the municipalities of Parana into...

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Veröffentlicht in:Omega (Oxford) 2015-04, Vol.52, p.53-64
Hauptverfasser: Steiner, Maria Teresinha Arns, Datta, Dilip, Steiner Neto, Pedro José, Scarpin, Cassius Tadeu, Rui Figueira, José
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Sprache:eng
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Zusammenfassung:Motivated by a proposal of the local authority for improving the existing healthcare system in the Parana State in Brazil, this article presents an optimization-based model for developing a better system for patients by aggregating various health services offered in the municipalities of Parana into some microregions. The problem is formulated as a multi-objective partitioning of the nodes of an undirected graph (or network) with the municipalities as the nodes and the roads connecting them as the edges of the graph. Maximizing the population homogeneity in the microregions, maximizing the variety of medical procedures offered in the microregions, and minimizing the inter-microregion distances to be traveled by patients are considered as three objective functions of the problem. An integer-coded multi-objective genetic algorithm is adopted as the optimization tool, which yields a significant improvement to the existing healthcare system map of the Parana State. The results obtained may have a strong impact on the healthcare system management in Parana. The model proposed here could be a useful tool to aid the decision-making in health management, as well as for better organization of any healthcare system, including those of other Brazilian States. •Work is motivated by a proposal of the local authority for improving the existing healthcare system in Parana.•Partitioning the healthcare map into some microregions is presented as a multi-objective optimization problem.•3 objectives are studied: maximize population homogeneity and medical procedures, and minimize inter-microregion traveling.•Applying an integer-coded multi-objective genetic algorithm, solutions better than the existing map could be obtained.•As per the preference information of the concerned healthcare authority, a compromised solution is also presented.
ISSN:0305-0483
1873-5274
DOI:10.1016/j.omega.2014.10.005