Article: A semi-Markov decision model for the optimal control of an emergency medical service system Journal: International Journal of Industrial and Systems Engineering (IJISE) 2024 Vol.46 No.2 pp.169 - 194 Abstract: A mathematical model for the analysis of an emergency medical service (EMS) system with a specific number of advanced life support units (ALS) and a specific number of basic life support (BLS) units is presented in this paper. The system admits incoming emergency calls which are divided into two classes: 1) urgent, high-priority calls for which the patient's life is potentially at risk; 2) less urgent low-priority calls. Under a suitable cost structure, the system is modelled using an appropriate Markov decision process in continuous time for which we seek a stationary policy that minimises a predefined optimality criterion for vehicle mixes over a set of candidate ambulance fleets. Based on this formulation, it is possible to implement standard Markov decision algorithms, such as the standard value-iteration algorithm and the standard policy-iteration algorithm. A sensitivity analysis of some model parameters is provided to examine their effect in the vehicle mix and in the cost of the system. An integer programming formulation is also provided for the corresponding location-allocation problem of the model. Numerical results are also presented for the examined problem. Inderscience Publishers - linking academia, business and industry through research

Title: A semi-Markov decision model for the optimal control of an emergency medical service system

Authors: Giannis A. Kechagias; Alexandros C. Diamantidis; Theodosis D. Dimitrakos

Addresses: School of Economics, Faculty of Economics and Political Sciences, Aristotle University of Thessaloniki, Greece ' School of Economics, Faculty of Economics and Political Sciences, Aristotle University of Thessaloniki, Greece ' School of Sciences, Department of Mathematics, University of the Aegean, Karlovassi, Samos, Greece

Abstract: A mathematical model for the analysis of an emergency medical service (EMS) system with a specific number of advanced life support units (ALS) and a specific number of basic life support (BLS) units is presented in this paper. The system admits incoming emergency calls which are divided into two classes: 1) urgent, high-priority calls for which the patient's life is potentially at risk; 2) less urgent low-priority calls. Under a suitable cost structure, the system is modelled using an appropriate Markov decision process in continuous time for which we seek a stationary policy that minimises a predefined optimality criterion for vehicle mixes over a set of candidate ambulance fleets. Based on this formulation, it is possible to implement standard Markov decision algorithms, such as the standard value-iteration algorithm and the standard policy-iteration algorithm. A sensitivity analysis of some model parameters is provided to examine their effect in the vehicle mix and in the cost of the system. An integer programming formulation is also provided for the corresponding location-allocation problem of the model. Numerical results are also presented for the examined problem.

Keywords: emergency medical service system; EMS; vehicle mix; Markov decision process; MDP; integer programming.

DOI: 10.1504/IJISE.2024.136414

International Journal of Industrial and Systems Engineering, 2024 Vol.46 No.2, pp.169 - 194

Received: 21 Oct 2021
Accepted: 29 May 2022
Published online: 01 Feb 2024 *

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Title: A semi-Markov decision model for the optimal control of an emergency medical service system

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