Alocação de leitos de internação com o uso da abordagem de otimização via simulação

Abstract

This research proposes a Simulation Optimisation approach for planning hospital beds capacity and allocation. The optimisation is conducted by the NSGA-II, a Genetic Algorithm suitable for framing and solving problems with multiple objectives. Each solution generated by it is evaluated through Parallel Simulation, because its analytical evaluation would imply on making several unrealistic and simplistic assumptions. An application was performed in one of the health regions of Minas Gerais, Brazil, where the public health system assists nearly 77% of the patients. The results showed that 1,179 public beds would be appropriate to minimise patients refusal rates, and that 188 more beds should be outsourced from the private system to achieve better service levels. Although this solution increases the beds daily costs by 13%, it reduces the refusal rates about 1/30th of its current values. Therefore, it is an alternative to empirical methods currently applied for planning the Brazilian hospitalisation system.