The nurse-to-patient assignment problem in home care services

The nurse-to-patient assignment problem in Home Care (HC) under continuity of care consists of allocating each newly admitted patient to only one reference nurse, without changing the assignment for a long period. The reference nurse of the new patient is chosen among a set of compatible ones, with the main goal of balancing the workloads among the nurses. In the literature, the assignment problem is usually solved with numerical approaches based on mathematical programming. In this chapter, we present a set of structural policies for solving the problem in the HC context. They take into account the randomness related to the patients’ demands and to the workloads already assigned to nurses. The goal is to minimize a stochastic cost function based on the time for visits provided by the nurses above their capacities. A comparison with the current practice of HC providers that assign the new patient to the nurse with the highest expected available capacity is also presented. To apply the policies, an estimation of patient requirements in the planning period is needed. For this purpose, this chapter also presents a patient stochastic model to describe the patient’s care pathway and his/her demands for visits over time. Finally, the application to a relevant real case is described, and the benefits deriving from implementing the proposed approach are shown.