Home health-care network design: Location and configuration of home health-care centers

Home Health-Care (HHC) is a concept slowly expanding over time, introduced to reduce pressure on inpatient hospital beds by providing care to patients at home. Nowadays, HHC centers are able to undertake more technical complex care such as (but not limited to) end-of-life care, chemotherapy and rehabilitation. This article accomplishes two main objectives: (i) design a home health-care network by locating HHC centers across a territory, taking into account medical demand and costs of resources and facilities; (ii) optimally manage the activities of HHC centers by deciding on the outsourcing of critical processes for patient care. Two mixed-integer linear programs are proposed to solve these problems and propose strategic and tactical decisions. A practical case study is proposed on the Loire department (France) with various scenarios to test the robustness of the model depending on demand variation. The proposed method gives efficient plans for designing and managing HHC centers with cost-efficient solutions on both strategic and tactical level.