An integrated nurse routing and rerostering problem for hospital-at-home

Hospital-at-home (HaH) enables patients with acute illnesses to receive care at home, improving their well-being and reducing healthcare costs. We study a weekly HaH operational planning problem, where patient admission, nurse routing, and rerostering decisions are made simultaneously. We develop two metaheuristic algorithms based on a large neighborhood search framework to first maximize the number of patients treated at home and then minimize the routing cost. We provide managerial insights, including the effects of time window length and rerostering limit.