Title: An integer programming model to assign patients based on mental health impact for tele-psychotherapy
intervention during the Covid–19 emergency
Citation: Miniguano-Trujillo, A., Salazar, F., Torres, R., Arias, P., & Sotomayor, K. (2021). An integer
programming model to assign patients based on mental health impact for tele-psychotherapy intervention
during the Covid–19 emergency. Health Care Management Science, 24(2), 286–304.
[Link]
Key Points:
● It addresses the mental health during the COVID-19 pandemic
● It utilized IP model for patient-therapist assignment, i.e., optimization of assignment of patients to
therapists for tele-psychotherapy interventions during the COVID-19 pandemic. The model was
validated with real-world data in Ecuador
○ The patient-therapist assignment was categorized for effective assignment
○ Objective Function: To maximize the global affinity between patients and therapists while
considering total contributions of therapists to the assignment, based on psychological criteria
and therapist skills
○ The model operates on a multi-periodic basis, meaning it accounts for multiple time periods in
which patient assignments occur. This allows for flexibility and adaptability in response to
changing patient needs and therapist availability over time
○ Constraints:
■ Patient Assignment Limits: The model includes constraints that ensure the maximum
number of patients assigned to each therapist does not exceed their capacity. This is
crucial for maintaining quality care and preventing therapist burnout.
■ Upper and Lower Bounds: Additional constraints impose upper and lower limits on
the number of patients each therapist can treat, ensuring that therapists are actively
engaged and that no therapist is overburdened.
■ Workload Distribution: The model also incorporates constraints to ensure a
homogeneous distribution of workload among therapists, which is essential for
maintaining balance and efficiency in the intervention process
■ Decision Variables:
● Patient Assignment Variables: These variables indicate whether a specific
patient is assigned to a particular therapist during a given time period. They are
binary in nature, taking values of 0 or 1, where 1 signifies that the patient is
assigned to the therapist, and 0 indicates no assignment. This allows for clear
tracking of which patients are receiving therapy from which therapists at any
given time.
● Therapist Capacity Variables: These variables represent the number of
patients assigned to each therapist. They help ensure that the total number of
patients assigned does not exceed the therapist's capacity, which is critical for
maintaining the quality of care and preventing therapist overload.
● Workload Distribution Variables: The model includes variables that help in
distributing the workload evenly among therapists. This is important to ensure
that no single therapist is overburdened while others are underutilized,
promoting a balanced approach to patient care.
● Categorization Variables: The model may also include variables that
categorize patients based on their psychological needs and therapists based on
their qualifications. This categorization is essential for making informed decisions
about assignments, ensuring that patients are matched with therapists who are
best suited to address their specific issues.
● Period Variables: Since the model operates on a multi-periodic basis, there are
variables that track the assignments over different time periods. This allows the
model to adapt to changing circumstances and patient needs over time.
Title: Research on outpatient capacity planning combining lean thinking and integer linear programming
Citation: Hua, L., Dongmei, M., Xinyu, Y., Xinyue, Z., Shutong, W., Dongxuan, W., Hao, P., & Ying, W. (2023).
Research on outpatient capacity planning combining lean thinking and integer linear programming. BMC
Medical Informatics and Decision Making, 23(1), 32. [Link]
Key Points:
● Focuses on outpatient capacity planning
● It combines lean thinking and integer linear programming
● Aims to improve doctors' efficiency and reduce patient waiting time
● Outpatient services are divided into examination and diagnosis
● The model enhances medical resource utilization and patient satisfaction.
● It addresses outpatient scheduling challenges in medical operations management.
● The primary goal of the model is to enhance doctors' work efficiency, reduce patient waiting times, and
provide satisfactory medical services.
○ Constraints:
■ Each doctor's working time, which includes diagnosis, examination, and transfer times,
must not exceed their predefined limits
■ The total number of patients transferred in and out by all doctors must remain constant,
ensuring that patient flow is managed effectively
■ The model also considers the appointment relationships between patients and doctors,
represented through a two-dimensional data structure, which helps in managing patient
assignments
○ Decision Variables:
■ The model defines decision variables that represent the appointment relationships and
the number of patients each doctor can handle. This allows for flexibility in patient
assignments and helps in optimizing the overall patient flow
Title: An Integer Programming Model for a Nurse Scheduling Problem
Citation: Suppiah, Y. (2023). An integer programming model for a nurse scheduling problem. International
Journal of Membrane Science and Technology, 10(2), 1180–1185. [Link]
Key Points:
The paper presents two distinct mathematical models aimed at addressing the nurse scheduling problem in
hospitals. Each model is designed to optimize the allocation of nurses while considering various constraints and
requirements.
● Model 1: Scheduling for 5 Consecutive Days
Objective: The primary goal of this model is to minimize the number of nurses scheduled per day while
ensuring that each nurse works for 5 consecutive days. This is crucial for maintaining a consistent workforce
and meeting patient care needs.
Decision Variables: The model introduces variables 𝑥𝑖 representing the nurses who start work on day 𝑖 (where
𝑖 = 1, 2,..., 7). For instance, 𝑥1 corresponds to nurses starting on Monday.
Constraints:
Equations 1 to 7 ensure that the minimum required number of nurses is met for each day of the week
(Monday to Sunday) without violating staffing requirements.
The model also includes a non-negativity constraint, ensuring that all variables are integers, which is essential
for practical scheduling.
● Model 2: Scheduling for 2 Consecutive Shifts
Objective: This model focuses on determining the optimal number of nurses required for each shift across
the week, specifically when nurses work two shifts consecutively.
Decision Variables: The model defines variables 𝑤𝑖𝑗 where 𝑖 indicates the day and 𝑗 indicates the shift. For
example, 𝑤11 represents the number of nurses starting on Monday for shift 1, while 𝑤23 represents those
starting on Sunday for shift 3.
Constraints:
Equations 1 to 21 ensure that the total number of nurses scheduled does not exceed the optimal number
required for each shift on each day.
The first constraint (Eq1) specifies that at least 80 nurses must work in shift 1 on Monday, ensuring adequate
coverage
Similar to Model 1, this model also includes non-negativity constraints and requires all variables to be integers,
which is critical for effective scheduling.
Conclusion
Both models utilize integer programming to address the complexities of nurse scheduling in hospitals. Model 1
focuses on daily staffing for nurses working five consecutive days, while Model 2 optimizes staffing for two
consecutive shifts. The application of these models aims to enhance operational efficiency in healthcare
settings while ensuring patient care needs are met effectively
Title: Comparison of different approaches applied in Analytic Hierarchy Process – an example of information
needs of patients with rare diseases
Citation: Pauer, F., Schmidt, K., Babac, A., Damm, K., Frank, M., & Von Der Schulenburg, J.-M. G. (2016).
Comparison of different approaches applied in Analytic Hierarchy Process – an example of information needs of
patients with rare diseases. BMC Medical Informatics and Decision Making, 16(1), 117.
[Link]
Key Points:
The mathematical model discussed in the paper primarily revolves around the Analytic Hierarchy Process
(AHP), which is a structured technique for organizing and analyzing complex decisions. Here are the key
components of the model as presented in the study:
Analytic Hierarchy Process (AHP):
AHP is used to prioritize patient needs and preferences regarding information related to rare diseases. It allows
for the systematic comparison of different criteria and alternatives by breaking down a complex decision into a
hierarchy of simpler decisions
Pairwise Comparisons:
The model employs pairwise comparisons where participants evaluate the relative importance of different
criteria. This is done on a scale of 1 to 9, where 1 indicates equal importance and 9 indicates extreme
importance of one criterion over another
Consistency Ratio (CR):
A critical aspect of the AHP is the consistency ratio, which measures the consistency of the judgments made by
participants. In this study, an acceptable CR was set at 0.2 for the second level of the hierarchy. If the CR
exceeds this threshold, it indicates that the judgments may not be consistent, leading to a reduction in the
number of included participants
Data Aggregation:
The study discusses different methods for aggregating data from individual and group judgments. The results
showed that the choice of aggregation method (median, arithmetic mean, or geometric mean) can slightly
affect the outcomes, but the overall trends remained consistent across methods
Sample Size and Participant Demographics:
The model was tested on a sample of participants diagnosed with rare diseases, with an average of 16.9 years
since diagnosis for individual participants. The demographic data, including marital status, was also collected
to provide context to the findings
In summary, the mathematical model in this study utilizes the AHP framework to systematically evaluate
patient priorities in the context of rare diseases, incorporating pairwise comparisons, consistency checks, and
ethical considerations to ensure robust and reliable results.
Title: A decision support system for the optimal allocation and distribution of COVID-19 vaccines using analytic
hierarchy process (AHP) and integer programming (IP) model
Citation: Culaste, H. F. C., Torres, N. J. D., Lachica, Z. P. T., Lorono, H. G. P., Inguillo, R. F., Mata, M. A. E., &
Namoco, R. A. (2023). A decision support system for the optimal allocation and distribution of COVID-19
vaccines using analytic hierarchy process (Ahp) and integer programming (Ip) model. Frontiers in Applied
Mathematics and Statistics, 9. [Link]
Key Points:
The Integer Programming (IP) model presented in the paper is a crucial component of the decision support
system (DSS) designed for the optimal allocation and distribution of COVID-19 vaccines. Here’s a detailed
breakdown of the IP model:
Objective Function: The primary goal of the IP model is to maximize the prioritization of individuals to be
vaccinated. This is achieved by incorporating prioritization scores, which are derived from the Analytic
Hierarchy Process (AHP) into the model's objective function. These scores act as weights that reflect the
importance of vaccinating certain groups over others.
Constraints: The model operates under specific constraints that are essential for realistic implementation.
These constraints include the number of available vaccines, the capacity of vaccination sites, and the number
of target individuals. The model ensures that the allocation adheres to these limitations, making it practical for
real-world application.
Integer Requirement: A significant aspect of the IP model is that it requires the decision variables (denoted
as 𝑥𝑖𝑗, representing the number of people to be vaccinated) to be integers. This is logical since it is not feasible
to vaccinate a fraction of a person or a negative number of individuals. Thus, the model is designed to handle
only whole numbers, ensuring that the outputs are applicable in a real-world context.
Dynamic Adjustments: The model is designed to be flexible, allowing for adjustments based on changes in
parameters such as the number of vaccines available or the target population. This adaptability is crucial, as
vaccination campaigns may vary significantly over time due to the evolving nature of the COVID-19 pandemic.
In summary, the IP model serves as a robust framework for optimizing vaccine distribution, integrating both
quantitative and qualitative factors to support decision-making in public health contexts. Its reliance on integer
programming ensures practical applicability, while its validation processes enhance its credibility as a decision
support tool.
Title: A decision support system for the optimal allocation and distribution of COVID-19 vaccines using analytic
hierarchy process (AHP) and integer programming (IP) model
Citation: Culaste, H. F. C., Torres, N. J. D., Lachica, Z. P. T., Lorono, H. G. P., Inguillo, R. F., Mata, M. A. E., &
Namoco, R. A. (2023). A decision support system for the optimal allocation and distribution of COVID-19
vaccines using analytic hierarchy process (Ahp) and integer programming (Ip) model. Frontiers in Applied
Mathematics and Statistics, 9. [Link]
Key Points:
Purpose of AHP: AHP is employed to derive prioritization weights for different communities based on multiple
criteria. This method helps decision-makers systematically evaluate and rank alternatives, which, in this case,
are the communities that need vaccination. The AHP allows for a clear understanding of how various factors
influence the decision-making process.
Criteria for Prioritization: The AHP model considers three main criteria for prioritizing communities:
● Cases: This criterion refers to the number of COVID-19 positive cases in a community. Communities
with higher case numbers are prioritized to mitigate the spread of the virus.
● Density: This criterion assesses the population density of the community, indicating how many
residents live in a given area. Higher density areas may require more urgent vaccination efforts due to
the increased risk of virus transmission.
● Distance: This criterion focuses on the geographical distance to vaccination sites, aiming to provide
convenience for individuals who need to be vaccinated.
Hierarchical Structure: AHP organizes the decision-making process into a hierarchical structure. The overall
goal is at the top, followed by the criteria (Cases, Density, Distance) in the second level, and the communities
being evaluated at the lowest level. This structure helps in visualizing the relationships between the goal,
criteria, and alternatives.
Pairwise Comparisons: A key feature of AHP is the use of pairwise comparisons. Decision-makers compare
each criterion against one another to establish their relative importance. Similarly, alternatives (communities)
are compared with respect to each criterion. This process helps in quantifying subjective judgments and
reduces bias in decision-making.
Consistency Check: AHP incorporates a technique for checking the consistency of the evaluations made by
decision-makers. This is crucial as it helps ensure that the comparisons are logical and reliable, thereby
enhancing the credibility of the prioritization results.
In summary, the AHP provides a systematic and structured approach to prioritize communities for COVID-19
vaccination based on critical criteria. By utilizing pairwise comparisons and a hierarchical structure, AHP aids in
making informed decisions that can effectively address the challenges posed by the pandemic.
Title: The use of analytic hierarchy process for measuring the complexity of medical diagnosis
Citation: Ben-Assuli, O., Kumar, N., Arazy, O., & Shabtai, I. (2020). The use of analytic hierarchy process for
measuring the complexity of medical diagnosis. Health Informatics Journal, 26(1), 218–232.
[Link]
Key Points:
Conceptualization of Complexity: AHP helps in breaking down the multi-dimensional construct of
diagnostic complexity into manageable components. This includes factors such as diagnosis difficulty, the
amount of work involved in diagnosing, and the risk of complications or comorbidities. By structuring these
elements hierarchically, AHP provides a clear framework for understanding the various aspects of diagnostic
complexity.
Operationalization with ICD Codes: The paper demonstrates how AHP can operationalize the concept of
diagnostic complexity by linking it to International Classification of Diseases (ICD) codes. This connection
allows for the use of readily available data, making the measurement process more accessible to practitioners
and researchers.
Pairwise Comparisons for Scoring: AHP requires experts to conduct pairwise comparisons among different
ICD categories to assign complexity scores. This method allows for a systematic evaluation of how each
diagnosis compares in terms of complexity. However, the number of comparisons increases exponentially with
the number of options, which can be a limitation in terms of the manual effort required.
Flexibility and Applicability: AHP is recognized for its flexibility and ease of use, making it suitable for
various medical domains. The paper encourages practitioners to apply AHP to different problems that can be
structured hierarchically, thereby enhancing decision-making in healthcare settings.
Predictive Reliability: The study highlights that despite its relatively simple procedure, the AHP approach
can predict outcomes, such as readmission rates, effectively. This reliability is comparable to more
sophisticated measures, indicating that AHP can serve as a robust tool for assessing diagnostic complexity.
Encouraging Future Research: By showcasing the potential of AHP in measuring diagnostic complexity, the
authors aim to inspire further research in this area. They hope that AHP will be utilized more widely in the
medical field to address complex constructs and improve healthcare decision-making.
In summary, AHP provides a structured and systematic approach to measuring diagnostic complexity, making it
a promising tool for healthcare professionals seeking to enhance their understanding and management of
complex medical diagnoses.
Title: AN AHP-BASED OPTIMAL DISTRIBUTION MODEL AND ITS APPLICATION IN COVID-19 VACCINATION
Citation: Garg, A., Sharma, Y. D., & Jain, S. K. (2021). An ahp based optimal distribution model and its
application in covid-19 vaccination. International Journal of the Analytic Hierarchy Process, 13(2).
[Link]
Key Points:
Development of an Optimal Distribution Model: The authors propose an AHP-based optimal distribution
model specifically designed for the COVID-19 vaccine. This model aims to eliminate human bias and
methodological errors that can arise from subjective judgments in decision-making processes.
Hierarchical Structure: The first step in the AHP model involves creating a hierarchy of decision elements
related to the vaccine distribution problem. This structured approach allows for a clear organization of factors
that influence the distribution strategy.
Pairwise Comparison Matrix (PCM): AHP employs a pairwise comparison method to assess the relative
importance of different decision elements. The authors utilize Saaty's fundamental scale to collect responses,
which are then used to construct a PCM. This matrix is essential for calculating preference weights for each
state and union territory involved in the vaccine distribution.
Geometric Mean AHP Analysis: The paper describes the use of the geometric mean method within AHP to
calculate state-wise preference weights. This method helps in determining the optimal distribution strategy
based on the varying availability of vaccines across different regions.
Real-Time Application: The AHP model developed in the paper is designed for real-time application,
allowing for adjustments based on the current availability of vaccines. This adaptability is crucial for effective
healthcare management during a pandemic.
Results and Discussion: The authors apply the AHP model to COVID-19 data, resulting in an optimal
state-level vaccine distribution strategy. The findings highlight the most affected states, such as Kerala and
Maharashtra, which are prioritized in the distribution process.
Future Recommendations: The authors suggest that the AHP-based model can be further utilized for
designing optimal vaccine distribution strategies at various administrative levels, including districts and
countries, as well as for developing inventory models for vaccine storage.
In summary, the paper effectively demonstrates the application of AHP as a systematic and unbiased approach
to solving the complex issue of COVID-19 vaccine distribution, showcasing its versatility and effectiveness in
healthcare management.
Title: Analytic hierarchy process for hospital site selection
Citation: Şahin, T., Ocak, S., & Top, M. (2019). Analytic hierarchy process for hospital site selection. Health
Policy and Technology, 8(1), 42–50. [Link]
Key Points:
Evaluation Criteria: In the study, AHP was employed to select the best site for a new hospital in Muğla,
Turkey, based on six main criteria and 19 sub-criteria. The criteria included factors like demand, accessibility,
and environmental conditions, which were essential for determining the most suitable location.
Ranking Alternatives: The districts in Muğla were evaluated as alternatives using a 1-9 Saaty scale, which is
a common method in AHP for ranking the importance of different criteria. This systematic ranking helps in
identifying the best option based on the established criteria.
Results and Findings: The results of the AHP analysis indicated that demand was the most critical factor in
site selection, followed by accessibility and competition. Ultimately, Bodrum was identified as the best site for
establishing a new hospital.
Flexibility and Application: AHP is noted for its flexibility, allowing it to be applied in various
decision-making contexts, including healthcare management and policy. It can effectively handle both
subjective and objective evaluations, making it a valuable tool for prioritizing venue indicators in healthcare
settings.
Future Research Directions: The paper suggests that future research could explore other multi-criteria
decision-making (MCDM) methods alongside AHP, such as fuzzy AHP and geographical information systems
(GIS), to enhance the decision-making process in hospital site selection.
In summary, AHP serves as a robust framework for systematically evaluating and prioritizing options in
complex decision-making scenarios, particularly in the context of healthcare investments.
Title: An integer programming model for the deployment of mobile health clinics
Citation: Li, A., Peng, J., Majeed, B., & Misra, S. M. (2024). An integer programming model for the deployment
of mobile health clinics. IISE Transactions on Healthcare Systems Engineering, 14(2), 141–152.
[Link]
Key Points:
The primary goal of the model is to maximize the coverage of immunization services provided by MHCs in
areas where demand overlaps between schools and their affiliated communities. This is referred to as the
mobile facility location with overlapped demand (MFL-OD).
Variables:
● Binary Variables: The model uses binary variables 𝑥𝑖 and 𝑦𝑗 to indicate whether a school 𝑖 or a census
tract 𝑗 is selected as a service spot, respectively.
● Integer Variables: The model defines integer variables 𝑢𝑖 and 𝑣𝑗 to represent the number of visits to
school 𝑖 and census tract 𝑗, aiming to maximize coverage.
Demand Representation: The model accounts for the demand for immunizations in both school zones and
census tracts.
Constraints: The model includes several constraints to ensure that the visits to schools and census tracts do
not exceed the available demand:
● Visits to school 𝑖 are capped by the demand in that school, considering overlapping demand already
covered by visits to census tracts.
● Visits to census tract 𝑗 are similarly capped by the demand in that tract.
● Additional constraints ensure that the total number of visits to schools and census tracts does not
exceed the total visits available.
Complexity: The paper highlights that the proposed BLCIP model is NP-hard, indicating that finding an exact
solution may be computationally challenging. To address this, a polynomial-time approximation algorithm is
proposed, which estimates the approximation ratio of the solution.
Implementation: The model is applied in a case study involving the Houston Independent School District,
demonstrating its practical efficacy in optimizing MHC deployment.
This integer programming model serves as a crucial tool for improving the operational management of mobile
health clinics, ultimately enhancing service coverage in communities with overlapping health needs.
Despite the availability of Pentavalent vaccines and their inclusion in routine immunization programs in the
Philippines, significant challenges remain in ensuring equitable vaccine distribution. Current allocation
strategies often rely on static distribution plans, which may not adequately address community-specific needs
such as population density, healthcare accessibility, and disease vulnerability. Furthermore, while several
studies have examined vaccine distribution frameworks for other diseases, there is a notable lack of research
focusing on the equitable allocation of vaccines specifically for pertussis. The scarcity of targeted studies on
Pentavalent vaccines, which also provide protection against diphtheria, tetanus, hepatitis B, and Haemophilus
influenza type B, highlights the need for an optimized and data-driven approach. This research addresses this
gap by integrating the Analytic Hierarchy Process (AHP) to prioritize communities and an Integer Programming
(IP) model for precise vaccine allocation, ensuring a fair and effective strategy for Taguig City that could be
scaled to other areas.
Due to the constraints regarding the supply of Pentavalent vaccines and their inclusion in routine immunization
programs in the Philippines, inequities in vaccine distribution remain a challenge, especially in highly populated
urban areas like Taguig City. While previous studies have explored the allocation of vaccines for prevalent
infectious diseases such as COVID-19 , there is a lack of research focusing on the optimal distribution of
pentavalent vaccines for pertussis. This gap emphasizes the importance of a systemic and optimized approach
to ensure equitable distribution of pentavalent vaccines based on data. To bridge this gap, the study integrates
the Analytic Hierarchy Process (AHP) to prioritize communities and an Integer Programming (IP) model to
allocate vaccines efficiently, ensuring equitable distribution in Taguig City and providing a method that can be
adapted to other regions.