Mobile healthcare service planning in rural areas: A hybrid record to record travel algorithm

Due to the economic infeasibility of establishing comprehensive healthcare facilities in sparsely populated areas and the responsibility of governments to ensure equal healthcare access for citizens, different approaches have been sought in healthcare service delivery. The Republic of Turkiye's Ministry of Health provides mobile healthcare services (MHS) to 9 million people monthly through 3400 healthcare facilities and 7500 doctors. This study focuses on the Mobile Healthcare Service Routing and Scheduling Problem (MHS-RSP). The objective of MHS-RSP is to determine the daily routes of doctors on a monthly basis to minimize total distance traveled, taking into account constraints such as working hours, route time, minimum service time per visit, and dedicated doctor assignments to villages. A mixed-integer mathematical model is developed to address the problem, which is NP-hard and equivalent to the multi-depot time-constrained periodic vehicle routing problem. To solve medium-and large-sized problems efficiently, a hybrid metaheuristic algorithm named "GCH-RRT" is introduced, based on greedy constructive heuristic(GCH) and record-to-record travel(RRT) metaheuristic. The performance of the mathematical model and the GCH-RRT algorithm is compared with existing service plans in Ankara, resulting in a 15.6% improvement with the mathematical model and a 22.3% improvement with the GCH-RRT algorithm in total distance traveled.