The advancement of medical science and the rise in life expectancy have led to an increased demand for medical and nursing care. However, the growth in available resources has not kept pace with this rising demand. In such a scenario, optimizing the use of existing resources alongside implementing alternative solutions like home healthcare becomes essential. This study aims to design a home healthcare system that accounts for uncertainties in patient requests during the planning process. To achieve this, a online stochastic approach is applied to the home healthcare routing and scheduling problem. Given the need for rapid generation of optimal or feasible solutions and the complexity of combining routing and caregiver-patient assignment problems, the research is divided into two phases: deterministic and online. In the first phase, a three-step method is employed, which includes balanced clustering, allocation of clusters to caregivers, and final routing and scheduling of caregivers. In the second phase, the proposed three-step method integrates deterministic and non-deterministic requests using an online optimization approach to enhance caregiver scheduling. The results indicate that the three-step algorithm successfully reached an optimal solution for the largest integrated model, reducing the solving time from 21,360 seconds to 28 seconds with an optimality gap of eight percent. Additionally, the online optimization approach improved responsiveness to changes during the planned period, with significant re-planning required in less than seven percent of cases as assessed by simulation-based qualification. Moreover, continuous care was maintained in over 50 percent of visits. Both planning phases were validated using data from the Macsa Home Healthcare Center to eva‎luate the algorithm's effectiveness against real-world scenarios. Ultimately, the best outcome of the online algorithm was achieved through two runs of the offline model and the online expected value approach, arriving at a solution in 10,939 seconds

مهدي مهنام

مهدي ايران پور

قاسم مصلحي , مهدي علينقيان