A fuzzy optimization approach to hierarchical healthcare facilities network design considering human resource constraint: A case study

The purpose of this study was to investigate designing a two-level hierarchical healthcare facilities network under human resource constraint. To this end, a mixed integer model has been proposed in which the location of facilities, optimal flow of patients between the levels of the network, capacity planning and the planning of the required human resources are considered as the most important decisions. The proposed model aimed to minimize the total costs including the costs for the establishment of facilities, the cost of setting up services in different facilities, the costs of non-fulfilled demand at the second level of the network and the travel costs for patients to receive a variety of services. In this model, some of the parameters were considered uncertain that in order to cope considered uncertainty credibility-based chance constraint programming method was used. Then, the proposed model was implemented for planning in the several districts of Sari city in Mazandaran province. Finally, sensitivity analysis was carried out on some parameters such as the maximum available human resources and the average number of referral of each patient zone to family physician centers. Results revealed that if the maximum available human resources increase by 50%, network costs will be considerably reduced since the shortage costs get zero.