Nisha Nataraj


Faced with increasing demand for home health care that is rising faster than the supply of resources needed to deliver it and drastic budget cuts, many home care agencies are struggling to remain operational. There is a need for efficient routing that doesn’t compromise on the quality of care achieved when a patient is visited by the same nurse over the entire period of care, also known as care-giver continuity or continuity of care. Because care periods often last more than 60 days, care-giver continuity causes scheduling decisions to have a long-term impact by potentially restricting the agency from making alternative assignments that could reduce routing costs. Our research aims to understand and quantify the benefit of utilizing time horizons of 60- 90 days when making routing decisions under the constraint of continuity of care. We do so by defining the Home Health Care Routing Problem (HHCRP) as a variant of the Vehicle Routing Problem (VRP), known as the Consistent VRP, that includes the continuity of care requirement. Unlike related literature on this problem which considers planning horizons of at most a week, computational experiments in a variety of settings suggest the importance of considering planning horizons of 2-3 months when developing schedules for care-givers. Given that it is almost impossible to have complete information about future patients that far ahead, we also present a method that enables planners to design schedules for care-givers in the face of such uncertainty and demonstrate its effectiveness computationally.

Library of Congress Subject Headings

Home care services--Management--Mathematical models; Vehicle routing problem

Publication Date


Document Type


Student Type


Department, Program, or Center

Industrial and Systems Engineering (KGCOE)


Mike R. Hewitt

Advisor/Committee Member

Michael E. Kuhl


Physical copy available from RIT's Wallace Library at RA645.3 .N38 2012


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