Planning Strategies for Home Health Care Delivery

In home health care, continuity of care, wherein a patient is always visited by the same nurse, can be just as important as cost, as it is closely correlated to quality of care. While a patient typically receives care for two to three months, such that assigning a nurse to a patient impacts operations for lengthy periods of time, previous research focusing on continuity of care uses planning horizons that are often a week or shorter. This paper computationally demonstrates that considering a long planning horizon in this setting has significant potential for savings. Initially, a deterministic setting is considered, with all patient requests during the planning horizon known a priori, and the routing cost of planning for two to three months is compared with the cost when planning is done on a weekly basis. With inherent uncertainty in planning for such a long time horizon, a methodology is presented that anticipates future patient requests that are unknown at the time of planning. Computational evidence shows that its use is superior to planning on a weekly basis under uncertainty.