AN ANALYTICAL FRAMEWORK FOR OPTIMAL PLANNING OF LONG-TERM CARE FACILITIES IN ONTARIO

Abstract

Long-term care facility network in Ontario, and in Canada as a whole, encounters critical issues regarding balancing demand with capacity. Even worse, it is faced with rising demand in the coming years. Moreover, there is an urgent need to provide long-term care for patients in their own language (particularly French). This study proposes a dynamic Mixed-Integer Linear Programming model based on the current standing of the long-term care system in Ontario, which simultaneously optimizes the time and location of constructing new long-term care facilities, adjusting the capacity (namely, human resources and beds) of each facility dynamically, and the assignment of patients to the facilities based on their demand region, gender, language, and age group over a finite time horizon. We apply the diversity-support constraints, based on patients’ gender and language, to save patients from loneliness and to comply with the Canadian values of providing care. Finally, we validate the model by performing a case study in Hamilton, Ontario. An extensive set of numerical analyses are explored to provide deeper insights into the whole issue. One set of such analysis is an extensive simulation study to examine the effect of distributional uncertainty in some of the input parameters on the optimal results, hence providing a much more realistic understanding of the optimization model.