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Optimization approaches to the ambulance dispatching and relocation problem
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In the Emergency Medical Service (EMS) context, the decision-making process plays a very important role since some decisions highly impact patients’ health. This thesis focuses on the operational level by solving the dispatching and relocation ambulance problems. Dispatching decisions assign ambulances to emergencies, and the relocation problem decides to which base ambulances should be (re)assigned. Two optimization approaches are proposed to improve the effectiveness and efficiency in the EMS response: a mixed-integer linear programming (MILP) model and a pilot method heuristic. The aim is to maximize the system’s coverage using a time-preparedness measure allowing relocations to any base.
Experiments are performed using EMS data from Lisbon, Portugal, where solving these problems is still a handmade task. Different ambulance types are considered, which should be used according to the severity of each emergency.
The proposed approaches are tested under different scenarios: varying the period size, varying the number of emergencies, and simulating a whole day. Furthermore, they are adapted to compare the proposed strategy with the current Portuguese EMS strategy, which dispatches the closest available ambulance for each emergency and always relocates ambulances to their home bases. Results highlight the potential of the mathematical model and of the proposed strategy to be applied in realtime contexts since a reduction of 10% is obtained in the average response time to emergencies in the simulation scenario. The heuristic should be used when more emergencies occur in the same time period since a solution can be obtained almost immediately in contrast to the MILP usage.
To help EMS managers in the decision-making process, we propose an ambulance management tool using Geographic Information Systems, which embeds the proposed approaches. It can be used in real-time or for simulation purposes. It incorporates a map visualization that analyzes ambulances’ movements on the map and the emergencies’ location.
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Palavras-chave
Serviço de Emergência Médica Gestão de Ambulâncias Despacho Realocação Sistemas de Informação Geográfica Emergency Medical Service Ambulance Management Dispatching Relocation Geographic Information Systems