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Authors
Advisor(s)
Abstract(s)
A saúde é um dos poderosos fatores de integração e coesão social, mas também de geração
de riqueza e bem-estar.
Nas sociedades desenvolvidas, o envelhecimento da população constitui uma evidência.
Portugal, assim como outros países da Europa, tem vindo a registar nas últimas décadas
profundas transformações demográficas caracterizadas, entre outros aspetos, pelo aumento
da longevidade e da população idosa e pela redução da natalidade e população jovem.
Assim, os cuidados de saúde domiciliários são cuidados prestados de forma continuada,
orientados para a resolução dos problemas de saúde das pessoas e cuja complexidade não
requer a sua institucionalização mas que, pela sua situação de dependência global, transitória
ou crónica, as impede de se deslocarem aos Centros de Saúde, distinguindo-se este
conceito por hospitalização domiciliária. Os cuidados de saúde domiciliários concretizamse
através de Visitas Domiciliárias, cuja periodicidade das visitas programadas varia em
função das necessidades de cuidados do doente e deverá ser estabelecida, consensualmente
na e em equipa, onde necessariamente se inclui o doente, o cuidador e/ou família, com
base nos resultados que se pretende atingir. Normalmente, as visitas são planeadas de
forma manual e sem apoio computacional.
Desta forma, torna-se imprescindível, para as Unidades de Saúde que desempenham
serviços de cuidados ao domicílio, otimizar os planeamentos relacionados. Assim, surge
o problema de planeamento de rotas para veículos (Vehicle Routing Problem, VRP), um
problema complexo de otimização combinatória bem conhecido, cujo objetivo é encontrar
a rota mais curta. Neste caso, para as equipas de profissionais de saúde, realizam procedimentos
médicos para pacientes doentes, na qual administram medicamentos e vários tipos de tratamentos.
Neste trabalho, pretende-se realizar o planeamento automático das visitas domiciliárias,
de uma Unidade de Saúde de Bragança, com o objetivo de minimizar o tempo total
despendido pelos enfermeiros e, desta forma, reduzir os custos envolvidos. Também se
pretende, com este trabalho verificar qual a metodologia mais eficaz para realizar as visitas
domiciliárias, comparando os resultados obtidos pela metodologia que irá ser abordada
com um algoritmo de programação inteira, com os resultados obtidos pela metodologia já
estudada em literatura, o Algoritmo Genético.
A metodologia desenvolvida foi testada no CPLEX, que permitiu resolver o problema
de forma eficiente e breve em tempo de resolução, obtendo as respetivas soluções de
planeamento das visitas domiciliárias para os dados apresentados. Em todos os horários
das visitas domiciliárias a realizar pelos enfermeiros, verificou-se uma redução significativa
do tempo gasto pelos enfermeiros, assim como, no tempo de espera dos pacientes.
Health is one of the powerful factors of social integration and cohesion, but also of wealth and well-being. In developed societies, the aging of the population is evidence. Portugal, as well as other European countries, has undergone deep demographic changes in recent decades, characterized by, among other aspects, the increase in longevity and the elderly population, the reduction of the birth rate and the young population. Therefore, home health care is a continuous of care directed at solving people’s health problems and whose complexity does not require institutionalization but which, because of their global, transitory or chronic dependence, prevents them from to the Health Centers, distinguishing this concept by home hospitalization. Home health care is carried out through Home Visits, whose periodicity of scheduled visits varies according to the patient’s care needs and should be established, consensually in and in a team, where necessarily includes the patient, caregiver and/or family, based on the results to be achieved. Usually visits are planned manually and without computer support. In this way, it is essential for the Health Units that perform home care services to optimize related planning. Thus, arises the Vehicle Routing Problem (VRP), a well-known complex combinatorial optimization problem, which aims to find the shortest route. In this case, for teams of healthcare professionals, they perform medical procedures for sick patients who administer medications and various types of use. In this study, we intend to carry out the automatic planning of home visits, from a Bragança Health Unit, with the aim of minimizing the total time spent by nurses and, in this way, reducing the costs involved. It is also intended, with this work, to verify which is the most effective methodology to make home visits, comparing the results obtained by the methodology that will be approached with an entire programming algorithm, with the results of the methodology already studied in the literature, or in the genetic algorithm. The developed methodology was tested in the CPLEX, which allowed to solve the problem in an efficient and brief way in resolution time, obtaining the respective solutions of home visits planning for the presented data. At all times of home visits by nurses, there was a significant reduction in the time spent by nurses, as well as in patients’ waiting time.
Health is one of the powerful factors of social integration and cohesion, but also of wealth and well-being. In developed societies, the aging of the population is evidence. Portugal, as well as other European countries, has undergone deep demographic changes in recent decades, characterized by, among other aspects, the increase in longevity and the elderly population, the reduction of the birth rate and the young population. Therefore, home health care is a continuous of care directed at solving people’s health problems and whose complexity does not require institutionalization but which, because of their global, transitory or chronic dependence, prevents them from to the Health Centers, distinguishing this concept by home hospitalization. Home health care is carried out through Home Visits, whose periodicity of scheduled visits varies according to the patient’s care needs and should be established, consensually in and in a team, where necessarily includes the patient, caregiver and/or family, based on the results to be achieved. Usually visits are planned manually and without computer support. In this way, it is essential for the Health Units that perform home care services to optimize related planning. Thus, arises the Vehicle Routing Problem (VRP), a well-known complex combinatorial optimization problem, which aims to find the shortest route. In this case, for teams of healthcare professionals, they perform medical procedures for sick patients who administer medications and various types of use. In this study, we intend to carry out the automatic planning of home visits, from a Bragança Health Unit, with the aim of minimizing the total time spent by nurses and, in this way, reducing the costs involved. It is also intended, with this work, to verify which is the most effective methodology to make home visits, comparing the results obtained by the methodology that will be approached with an entire programming algorithm, with the results of the methodology already studied in the literature, or in the genetic algorithm. The developed methodology was tested in the CPLEX, which allowed to solve the problem in an efficient and brief way in resolution time, obtaining the respective solutions of home visits planning for the presented data. At all times of home visits by nurses, there was a significant reduction in the time spent by nurses, as well as in patients’ waiting time.
Description
Keywords
Programação inteira Cuidados domiciliários Otimização VRP