Home healthcare in Spanish rural areas: Applying vehicle routing algorithms to health transport management

Depopulation of rural areas poses a range of new challenges for the provision of public services. Access to primary care centres is essential for promoting and protecting quality of life, especially for the older population. However, many rural municipalities face abandonment from public administrations by not even having a local clinic and forcing their dwellers to drive to the nearest facility. This research examines the adequacy of providing home healthcare (HHC) systems in such areas to avoid unnecessary trips. When designing routes to provide these services, decision-makers must take into account the following: (i) wide geographical spread of places to visit; (ii) difficulty in accessing some of these places with heavy medically equipped vehicles; and (iii) uncertainty regarding places to visit and availability of professionals. Our study identifies municipalities in which the travelling distance to the closest centre is above a desirable threshold, estimating the magnitude of the problem. Then, we provide an illustrative example in which an agile methodology is presented to design efficient routes that allow policymakers to offer HHC services of reasonable quality.