Applying the cardinality-constrained approach in health care systems: the home care example

Many approaches are applied to deal with uncertainty in health care optimization problems. However, a recently proposed technique, namely, the cardinality-constrained approach, is only marginally applied in health care. This approach accounts for a given degree of uncertainty with a reasonable computational effort, providing a trade-off between computational time and robustness. In this paper, we apply such approach to the nurse-to-patient assignment problem under continuity of care arising in home care services. A linear programming model is developed for solving the problem, and the robustness is included in the formulation according to the cardinality-constrained approach. The overall robust model is applied to a Home Care provider operating in Italy, in order to evaluate its capability of reducing the costs related to nurses' overtimes, and to compare the results both with the real practice of the analyzed provider and with previously developed approaches. Relevant benefits are achieved by applying the proposed model in the practice, and results suggest that such benefits could be also achieved in other optimization problems within the health care domain. © Springer International Publishing Switzerland 2014.