Multi-Objective Optimization of Home Healthcare with Working-Time Balancing and Care Continuity

The ageing population in most parts of the world becomes a grand challenge for healthcare decision-makers. The care of elderly persons and general hygienic care at patients' homes are two main reasons to motivate an optimization problem, namely, home healthcare (HHC). A robust plan for caregivers to have sustainable HHC operations management is to consider working-time balancing of caregivers, care continuity and uncertainties, e.g., the uncertainty of patients' availability in addition to service and travel times as well as the regulations of companies to meet the standards of high-quality home care services. Based on these motivations and challenges to this field, this study firstly established a multi-objective robust optimization of the HHC which is multi-depot, multi-period and multi-service. The demand of each patient in each period may be different due to promptness of services. Each caregiver plays one of the roles of nurses, doctors, physiotherapists and nutritionists. The types of services are directly related to these roles. The objectives were optimizing the total cost of logistic activities as well as the total unemployment time of caregivers and care continuity. As a complicated optimization problem, this study innovated efficient heuristics and an enhanced nature-inspired metaheuristic. Finally, an extensive comparison with regards to the criteria of the multi-objective algorithms' assessment was conducted. Some sensitivity analyses were conducted to conclude some practical insights.