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An application of constraint solving for home health care

机译：约束求解在家庭医疗保健中的应用

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摘要

Although sometimes it is necessary, no one likes to stay in a hospital, and patients who need to stay in bed but do not require constant medical surveillance prefer their own bed at home. At the same time, a patient in a hospital has a high cost for the community, that is not acceptable if the patient needs service only a few minutes a day. For these reasons, the current trend in Europe and North-America is to send nurses to visit patients at their home: this choice reduces costs for the community and gives better quality of life to patients. The challenge is to deliver the service in a cost effective manner without a detriment of the service quality. These social and health management issues have interesting implications from the mathematical viewpoint, introducing a challenging combinatorial optimization problem. The problem consists in assigning patients' services to traveling nurses and defining the nurse itineraries so that the following optimization aspects are considered: the nurse workloads (including service as well as travel time) are balanced, patients are preferentially served by a single nurse or just a few ones, and the overall travel time is minimized. These objectives are somehow conflicting and a reasonable trade off must be found. The complexity of the problem calls for suitable optimization-based algorithmic support to decisions, in particular in the perspective of an increasing diffusion of the service.
机译：尽管有时有必要，但没人喜欢留在医院，并且需要卧床但不需要持续医疗监视的患者更喜欢在家中自己的床。同时，医院的患者对社区的花费很高，如果患者每天仅需要几分钟的服务，这是不可接受的。由于这些原因，欧洲和北美当前的趋势是派遣护士在家中拜访患者：这种选择降低了社区成本，并为患者提供了更好的生活质量。面临的挑战是在不损害服务质量的前提下以经济高效的方式交付服务。从数学的角度来看，这些社会和健康管理问题具有有趣的含义，从而引入了具有挑战性的组合优化问题。问题在于将患者的服务分配给旅行的护士并定义护士的行程，以便考虑以下优化方面：平衡护士的工作量（包括服务和旅行时间），优先由一名护士或仅由一名护士为患者服务几个，总的旅行时间被最小化。这些目标在某种程度上是矛盾的，必须找到合理的权衡。问题的复杂性要求为决策提供适当的基于优化的算法支持，尤其是在服务扩散日益扩大的角度上。

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