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Acute and semi-acute events at home disrupt operational performance and require new planning and control approaches. This study examines an acute care team for unplanned and urgent home healthcare needs, deciding nurse numbers per care level and standby locations. A chance-constrained program is formulated, solved exactly for a single location and via sample average approximation for multiple locations.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/a-chance-constrained-program-for-the-allocation-of-nurses-in-acute-home-healthcare/454977/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/a-chance-constrained-program-for-the-allocation-of-nurses-in-acute-home-healthcare/454977.png","ImageObject",300,407,{"name":92,"@type":93},"Marglet","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What operational problem does the study address in home healthcare?","Question",{"text":112,"@type":113},"It addresses planning and control for unplanned and urgent acute home healthcare activities that disrupt operational performance.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What decisions does the model determine for the acute care team?",{"text":117,"@type":113},"It determines the number of nurses per care level and the standby locations.",{"name":119,"@type":110,"acceptedAnswer":120},"How is the chance-constrained program solved?",{"text":121,"@type":113},"The single-location problem is solved to optimality, while the multi-location problem uses sample average approximation.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},454977,1790821583,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},2336477982702,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","HEALTH SYSTEMS  \n2025, VOL. 14, NO. 4, 276–290  \n[https://doi.org/10.1080/20476965.2025.2467643](https://doi.org/10.1080/20476965.2025.2467643)  \n| RESEARCH ARTICLE   \u003Cbr>A chance-constrained program for the allocation of nurses in acute home healthcare\u003Cbr>Jedidja Lok-Visser, Hayo Bos, Erwin W. Hans and Gréanne Leeftink\u003Cbr>Center of Healthcare Operations Improvement and Research, Industrial Engineering & Business Information Systems, University of Twente, Enschede, The Netherlands |  |  |\n| --- | --- | --- |\n| ABSTRACT |  | ARTICLE HISTORY |\n| Home healthcare capacity is under great pressure due to demographic developments. Existing literature has exclusively focused on the planning, scheduling, and routing of non-acute care activities. However, similar to other healthcare settings, home healthcare also experiences acute care activities that disrupt operational performance. We study the planning and control of an acute care team for dealing with unplanned and urgent home healthcare activities. Particularly, we focus on determining the number of nurses per care level and their standby locations. The primary aim of this study is to introduce this novel problem, which we define asthe acute care team location problem. We formulate this problem as a chance-constrained program. We solve the single location problem to optimality, and the multi-location problem with sample average approximation. The results show that our approach enables decision makers to optimally configure their acute care team, to respond quickly to acute care incidents. From a managerial perspective, our research provides a model that supports tactical capacity planning in HHC organisations and presents a benchmark for acute care management policies. |  | Received 6 February 2024 Accepted 10 February 2025\u003Cbr>KEYWORDS\u003Cbr>Home healthcare; acute care management; healthcare facility planning; chanceconstraints; capacity planning; probabilistic set covering problem |\n| 1. Introduction\u003Cbr>Home healthcare (HHC) is medical care that is given to a patient at home, rather than in a healthcare facility. Due to ageing populations, demand for HHC services is increasing. Meanwhile, the supply of HHC capacity is decreasing in the Netherlands (Hammink, Mohammadi, & Interreg North Sea 2024), as is also reported in the United States (Scales, 2020) . This concerns informal HHC caregivers (Genet et al., 2011; Tarricone & Tsouros, 2008), who are individuals, outside of a professional or formal framework, that have a significant personal relationship with, and who provide a broad range of unpaid assistance to an older person or a person with a chronic or disabling condition (Lilleheie et al., 2020) . It also concerns professional nurses, of which there is also a worldwide shortage (McGrath, 2020; Weerdt & Baratta, 2015) .\u003Cbr>These developments require efficient and effective use of the available capacity by optimising the planning and routing of nurses, which has been a frequently studied topic in recent years (Cissé et al., 2017; DiMascolo et al., 2017; Eenoo et al., 2018; Goodarzian et al., 2023) .\u003Cbr>The planning and routing of HHC nurses increases in complexity when demand uncertainty is taken into account (Cappanera et al., 2018; Du et al., 2019; Hewitt et al., 2016) . Demand uncertainty is amongst others caused by acute incidents, such as fall incidents, and | semi-acute incidents, such as changing a colostomy bag. Two emerging initiatives in healthcare, Hospital at Home and Outpatient Parenteral Antimicrobial Therapy, aim to shift hospital care to patients’ homes (Leff et al., 2005; Sadler et al., 2021) . This increases the number of acute incidents at home. For instance, incidents with infusion pumps could happen, requiring round-the-clock availability of HHC providers These acute HHC incidents frequently delay nurses, which affects the highly valued consistent timing of HHC (Woodward et al., 2004) . However, the research to date has had only a limited focus on the management ","cbCaibjsPzIEsaSo","https://ap.wps.com/l/cbCaibjsPzIEsaSo","pdf",1204065,15,"English","# Abstract\n# 1. Introduction","[{\"question\":\"What operational problem does the study address in home healthcare?\",\"answer\":\"It addresses planning and control for unplanned and urgent acute home healthcare activities that disrupt operational performance.\"},{\"question\":\"What decisions does the model determine for the acute care team?\",\"answer\":\"It determines the number of nurses per care level and the standby locations.\"},{\"question\":\"How is the chance-constrained program solved?\",\"answer\":\"The single-location problem is solved to optimality, while the multi-location problem uses sample average approximation.\"}]","A chance-constrained program for the allocation of nurses in acute home healthcare | PDF",1790741828,38]