Multi-objective optimization in partitioning the healthcare system of Parana State in Brazil

Motivated by a proposal of the local authority for improving the existing healthcare system in the Parana State in Brazil, this article presents an optimization-based model for developing a better system for patients by aggregating various health services offered in the municipalities of Parana into some microregions. The problem is formulated as a multi-objective partitioning of the nodes of an undirected graph (or network) with the municipalities as the nodes and the roads connecting them as the edges of the graph. Maximizing the population homogeneity in the microregions, maximizing the variety of medical procedures offered in the microregions, and minimizing the inter-microregion distances to be traveled by patients are considered as three objective functions of the problem. An integer-coded multi-objective genetic algorithm is adopted as the optimization tool, which yields a significant improvement to the existing healthcare system map of the Parana State. The results obtained may have a strong impact on the healthcare system management in Parana. The model proposed here could be a useful tool to aid the decision-making in health management, as well as for better organization of any healthcare system, including those of other Brazilian States.     

Multi-objective simulation optimization using data envelopment analysis and genetic algorithm: Specific application to determining optimal resource levels in surgical services

Simulation is a powerful tool for modeling complex systems with intricate relationships between various entities and resources. Simulation optimization refers to methods that search the design space (i.e., the set of all feasible system configurations) to find a system configuration (also called a design point) that gives the best performance. Since simulation is often time consuming, sampling as few design points from the design space as possible is desired. However, in the case of multiple objectives, traditional simulation optimization methods are ineffective to uncover the efficient frontier. We propose a framework for multi-objective simulation optimization that combines the power of genetic algorithm (GA), which can effectively search very large design spaces, with data envelopment analysis (DEA) used to evaluate the simulation results and guide the search process. In our framework, we use a design point's relative efficiency score from DEA as its fitness value in the selection operation of GA. We apply our algorithm to determine optimal resource levels in surgical services. Our numerical experiments show that our algorithm effectively furthers the frontier and identifies efficient design points.