Résumé indisponible. / A healthcare network or health system consists of all organizations, actions and people who participate to promote, restore or maintain people’s health. The health care systems in many developed countries are facing increasing costs. The major reason is the changing age distribution of the population with more elderly people in need of support. Increasing healthcare costs has created new alternatives to traditional hospitalization in which one is Home Health Care (HHC). Home health care or domiciliary care is the provision of health care and assistance to people in their own homes, according to a formal assessment of their needs. HHC has attained a specific place in healthcare network. HHC programs have now been successfully implemented in many countries. The purpose of HHC is to provide the care and support needed to assist patients to live independently in their own homes. HHC is primarily performed by means of personal visitations of healthcare workers to patients in their homes, where they provide care assistance according to patients’ needs. In this thesis we have considered different aspects of planning problems for home health care services. The efficient use of resources is necessary in continuous healthcare services. To meet the increased demand of HHC, operation research specialist can play an important role by solving the various combinatorial optimization problems arising in HHC. These problems can be tactical, strategic or operational with respect to planning horizon. Strategic problems are those which help in attaining long term goals or objectives, e.g. higher level of quality for HHC patients and efficient use of resources. These strategic objectives can be achieved through tactical i.e. medium term panning and operational planning i.e. short term planning. The main purpose of our thesis is to identify these potential optimization problems and solve them via recent metaheuristics. HHC is an alternative to traditional hospitalization and has got a significant share in the organization of healthcare in developed countries. The change in aging demographics, recent development in technology and the increase in the demand of healthcare services are major reasons for this rapid growth. Some studies show HHC as a tool to reduce costs of care, which is a major preoccupation in developed countries. Some others reveal that it leads to the improvement of patients’ satisfaction without increasing the resources. Home health care, i.e. visiting and nursing patients in their homes, is a flourishing realm in the medical industry. The number of companies has grown largely both in public and private sectors. The staffing needs for HHC companies have been expanded as well. Also they face the problem of assigning geographically dispersed patients to home healthcare workers and preparing daily schedules for these workers. The challenge of this problem is to combine aspects of vehicle routing and staff rostering. Both of them are well known NP- hard combinatorial optimization problems, it means the amount of computational time required to find solution increases exponentially with problem size. Home healthcare workers scheduling problem is difficult to solve optimally due to presence of large number of constraints. These are two types of constraints: hard constraints and soft constraints. The hard constraints are the restrictions to be fulfilled for the schedules to be applicable and soft constraints are preferences to improve the quality of these schedules. (...)
| Identifer | oai:union.ndltd.org:theses.fr/2013CLF22391 |
| Date | 15 November 2013 |
| Creators | Bashir, Bushra |
| Contributors | Clermont-Ferrand 2, Caux, Christophe, Chabrol, Michelle |
| Source Sets | Dépôt national des thèses électroniques françaises |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation, Text |
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