Article ID: | iaor20171677 |
Volume: | 20 |
Issue: | 2 |
Start Page Number: | 165 |
End Page Number: | 186 |
Publication Date: | Jun 2017 |
Journal: | Health Care Management Science |
Authors: | Bhulai S, Mei R, Barneveld T |
Keywords: | health services, management, combinatorial optimization, simulation, graphs, heuristics, decision, performance |
We study the Dynamic Ambulance Management (DAM) problem in which one tries to retain the ability to respond to possible future requests quickly when ambulances become busy. To this end, we need models for relocation actions for idle ambulances that incorporate different performance measures related to response times. We focus on rural regions with a limited number of ambulances. We model the region of interest as an equidistant graph and we take into account the current status of both the system and the ambulances in a state. We do not require ambulances to return to a base station: they are allowed to idle at any node. This brings forth a high degree of complexity of the state space. Therefore, we present a heuristic approach to compute redeployment actions. We construct several scenarios that may occur one time‐step later and combine these scenarios with each feasible action to obtain a classification of actions. We show that on most performance indicators, the heuristic policy significantly outperforms the classical compliance table policy often used in practice.