مدیریت زنجیره تأمین

مدیریت زنجیره تأمین

مدل چندهدفه استوار مکان‌یابی–تخصیص مراکز درمانی موقت تحت عدم‌قطعیت تقاضا و محدودیت تأمین تجهیزات

نوع مقاله : پژوهشی

نویسنده
استادیار گروه مدیریت صنعتی، دانشکده مدیریت و علوم مالی، دانشگاه خاتم، تهران
چکیده
افزایش بحران‌های سلامت، همه‌گیری‌ها و محدودیت‌های تأمین تجهیزات پزشکی، ضرورت طراحی شبکه‌های درمانی تاب‌آور و استوار را بیش از پیش آشکار کرده است. در چنین شرایطی، تصمیم‌گیری درباره مکان‌یابی مراکز درمانی، تخصیص بیماران، ظرفیت‌گذاری و تأمین تجهیزات پزشکی تحت عدم‌قطعیت، به یکی از چالش‌های اصلی نظام سلامت تبدیل شده است. پژوهش حاضر یک مدل برنامه‌ریزی خطی مختلط عدد صحیح چندهدفه برای مکان‌یابی استوار مراکز درمانی با ملاحظات تاب‌آوری خدمت‌محور ارائه می‌دهد که تصمیمات مکان‌یابی، تخصیص خدمات، ظرفیت‌گذاری و تأمین تجهیزات پزشکی را به‌صورت یکپارچه و تحت عدم‌قطعیت تقاضا و محدودیت تأمین تجهیزات در نظر می‌گیرد. برای مدل‌سازی عدم‌قطعیت، از رویکرد بهینه‌سازی استوار مبتنی بر چارچوب Mulvey استفاده شده است که علاوه بر حداقل‌سازی هزینه مورد انتظار، پایداری عملکرد سیستم در سناریوهای مختلف را نیز لحاظ می‌کند. همچنین، به‌منظور تقویت تاب‌آوری خدمت‌محور شبکه، محدودیت کنترل کمبود خدمات و جریمه کمبود در مدل اعمال شده است. مدل پیشنهادی دارای دو تابع هدف شامل حداقل‌سازی هزینه کل استوار و حداقل‌سازی شاخص دسترسی بیماران به خدمات درمانی است. مدل با استفاده از روش ε-constraint در محیط GAMS و حل‌کننده HiGHS حل شد. برای ارزیابی محاسباتی، علاوه بر مثال تشریحی، 15 مسئله در سه اندازه کوچک، متوسط و بزرگ بررسی شد و مدل پیشنهادی با مدل قطعی ارزش مورد انتظار و مدل سناریومحور بدون جمله استواری مقایسه گردید. تصمیمات حاصل از سه مدل نیز در مجموع در 750 ارزیابی خارج از نمونه آزمون شدند. نتایج جبهه پارتو نشان داد که در راه‌حل میانی جبهه پارتو، افزایش 44/7 درصدی هزینه استوار، شاخص دسترسی را 80/18 درصد بهبود می‌دهد. همچنین، در ارزیابی خارج از نمونه، مدل پیشنهادی در مقایسه با مدل قطعی، متوسط هزینه و بیشترین هزینه مشاهده‌شده را به‌ترتیب 12/56 و 90/83 درصد کاهش داد و پوشش کامل تقاضا را در برابر پوشش 93/96 درصدی مدل قطعی حفظ کرد. یافته‌ها بیانگر آن است که برنامه‌ریزی سناریومحور و کنترل استواری تصمیمات می‌تواند با کاهش کمبود خدمات و حفظ پوشش تقاضا، تاب‌آوری خدمت‌محور شبکه سلامت را تقویت کند.




کلیدواژه‌ها
موضوعات

عنوان مقاله English

A Robust Multi-Objective Location–Allocation Model for Temporary Healthcare Centers under Demand Uncertainty and Medical Equipment Supply Constraints

نویسنده English

Fatemeh Mojibian
Assistant Professor of Management Department, Faculty of Management and Financial Science, Khatam University, Tehran, Iran
چکیده English

The increasing frequency of health crises, pandemics, and constraints on medical equipment supply has highlighted the growing need to design robust and resilient healthcare networks. Under such conditions, decisions concerning the location of healthcare centers, patient allocation, capacity planning, and medical equipment procurement under uncertainty have become major challenges for healthcare systems. This study develops a multi-objective mixed-integer linear programming model for the robust location–allocation of temporary healthcare centers with service-oriented resilience considerations. The proposed model integrates facility location, service allocation, capacity planning, and medical equipment procurement decisions under demand uncertainty and medical equipment supply constraints. To address uncertainty, a robust optimization approach based on the Mulvey framework is employed, which accounts for both expected cost minimization and the stability of system performance across different scenarios. In addition, a service-shortage control constraint and a shortage penalty are incorporated to strengthen the service-oriented resilience of the network.The proposed model includes two objective functions: minimizing the total robust cost and minimizing the patient accessibility index. The model was solved using the ε-constraint method in GAMS with the HiGHS solver. For computational evaluation, in addition to an illustrative example, 15 test instances in three sizes—small, medium, and large—were examined. The proposed model was also compared with a deterministic expected-value model and a scenario-based model without the robustness term. The decisions generated by the three models were evaluated through a total of 750 out-of-sample assessments. The Pareto-front analysis showed that, at the compromise solution, a 7.44% increase in robust cost improved the accessibility index by 18.80%. Moreover, the out-of-sample results indicated that, compared with the deterministic model, the proposed model reduced the mean and worst observed costs by 56.12% and 83.90%, respectively, while maintaining full demand coverage, compared with 96.93% coverage under the deterministic model. The findings indicate that scenario-based planning and robustness control can strengthen the service-oriented resilience of healthcare networks by reducing service shortages and maintaining demand coverage.

کلیدواژه‌ها English

Healthcare Facility Location
Medical Equipment Supply Chain
Robust Optimization
Health System Resilience
Demand uncertainty

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دوره 28، شماره 91 - شماره پیاپی 91
شماره پیا پی 91 تابستان 1405
تابستان 1405
صفحه 119-142

  • تاریخ دریافت 25 اردیبهشت 1405
  • تاریخ بازنگری 25 تیر 1405
  • تاریخ پذیرش 06 شهریور 1405
  • تاریخ انتشار 01 شهریور 1405