A Home Health Care Districting Problem in a Rapid-Growing City.

The districting problem in home health care (HHC) is part of the logistics decisions that healthcare providers face when designing service networks to deliver coordinated medical care to patients' homes. In this paper we study such problem in the context of a rapid-growing city, phenomenon that refers to the increment of the population in urban areas, and which results in problems such as the proliferation of marginal neighborhoods, increment of epidemic diseases, absence of governmental control and security, and lack of basic health services. Consequently, three factors derived from this phenomenon are integrally studied: geographical disposition of the population, security conditions to access basic units, and trends on demand for HHC services. We propose a bi-objective mathematical model and identify trade-offs, allowing finding better compromised solutions. We evaluate the model with real data instances from a HHC institution which delivers services in the largest cities in Colombia. Results show that better districting configurations can be obtained and deteriorations of less than 10% in Travel Workload can produce improvements of more than 80% in Workload Deviations. [ABSTRACT FROM AUTHOR]