| With the deepening of China’s aging,the social burden and the pressure of medical and health system are increasing,and China has gradually established a coordinated pension service system for families,communities and institutions.As one of the main modes of China’s old-age service system,home health care provides a feasible path to alleviate the social burden and the pressure of the medical and health system,and also provides an important support and strong guarantee for further improving the ability of prevention and treatment and health management at the grassroots level.The per capita medical expenditure in China is increasing year by year,which reflects the improvement of people’s requirements for the quality of home health care services,which brings new challenges to the balance between operating costs and service quality of home health care institutions.However,with the rapid development of economy and society,the problem of urban traffic congestion caused by the increase of car ownership in China is becoming increasingly serious.Road congestion is the primary factor affecting the punctuality of home health care services,so it is very necessary to consider the time-varying situation of speed in home health care issues.Therefore,this thesis studies the path planning and scheduling of home medical care,and comprehensively considers the actual situation of caregiver-patient matching and time-varying speed,focusing on the influence of timevarying speed scenarios,time window width and decision-making preferences on decision-making results,in order to provide theoretical guidance and scientific basis for personnel assignment and scheduling in home medical care institutions.The main contents are as follows:First of all,combined with the changing law of driving speed in the actual road network,the problem of home health care scheduling considering caregiver-patient matching is studied.Focusing on the characteristics of nurses’ driving speed changing with time,patients’ preference for nurses’ qualification grade and patients’ preference for time window,a bi-objective mixed integer programming model was established to minimize the operating cost of nursing institutions and minimize the punishment of qualification grade.Secondly,ASNSGA-Ⅱ algorithm is proposed to solve the problem.At the same time,mixed initial solution strategy,caregiver-patient matching crossover strategy and variable neighborhood strategy are introduced to improve the performance of the algorithm,and the optimal parameter combination of the algorithm is determined by orthogonal test.Finally,Solomon data set is used to generate an example and numerical experiments are carried out to verify the effectiveness and superiority of the designed ASGAVNS algorithm,and the effects of time-varying speed scenarios,time window width and decision preferences on the decision results are discussed.The research shows that:(1)the time-varying speed will have a significant impact on the decision-making results.The lower the peak driving speed,the more medical staff need to be appointed,which will lead to the increase of the starting cost and the penalty cost of early diagnosis and treatment;(2)The smaller the width of the patient’s time window,the more nurses need to be dispatched,which leads to the increase of the starting cost and the obvious reduction of overtime cost,while the change of the penalty cost of early diagnosis and treatment is related to the absolute value of the width of the patient’s demand time window;(3)Home health care institutions can adopt different preference decisions according to the target user groups,so as to better balance the cost and patient satisfaction. |
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