Reconfiguring State Health Services Logistics : Patients Flow Optimization

This paper presents an optimization to the flow patients for state health services offered to Parana State citizens and also analyzes a new optimized configuration for it. In Brazil, medical care is controlled by state officers, and is provided throughout a centralized planning managed by state governments in every one of Brazil’s 28 states. Since geographical area is a key factor in most states, and range of services are not the same for every unit, patients demanding my have to be transported to another facility, located in the same state. A new proposition is made for state division into smaller regions, with a service level assigned for each municipality. Cities with lower levels offer just basic procedures, and patient in need of a more specialized service are sent to higher level cities. The assignment for the groups of cities must be based on size of population, health facilities, road availability and patient transportation routes should be planned for each procedure in every facility. For the regional division, a branch-and-price algorithm was used, using the column generation algorithm for each node in the branch-and-bound tree. The results obtained were considered very consistent.