Operations management in the home care services: a heuristic for the caregivers’ routing problem

Home Care Services (HCS) aim at providing complex coordinated health care for patients at their homes. This paper addresses the challenges of routing and scheduling HCS caregivers under precedence and coordination constraints, with patients receiving multiple caregivers. Moreover, the visits are performed simultaneously and possibly in a predefined order. The routing problem involves a fleet of vehicles to serve a number of customers at different locations. The objective is to find the minimal round for vehicle, while satisfying all the customers and without violating customers’ time windows. It has been proved that the complexity of the caregivers routing problem is linked to both (1) the number of care activities per caregiver ratio and (2) the temporal dependencies rate. Given the poor performance of the mathematical modeling based on exact approaches, a heuristic approach called the Caregivers Routing Heuristic (CRH) has been developed and tested using real size instances. In fact, the exact approaches are not able to solve real size instances. The performance of the CRH has been evaluated using real size instances. The numerical results show that the CRH is very efficient in terms of computation times. Otherwise, the CRH is less sensitive than the exact approaches to both complexity axes: the temporal dependencies constraints and the ratio of the number of care activities per caregiver.