A multi-objective location-allocation model in mass casualty events response
Authors: Pouraliakbarimamaghani Mahsa , Mohammadi Mohammad , Mirzazadeh Abolfazl 
Published: December 2017

Purpose
When designing an optimization model for use in a mass casualty event response, it is common to encounter the heavy and considerable demand of injured patients and inadequate resources and personnel to provide patients with care. The purpose of this study is to create a model that is more practical in the real world. So the concept of “predicting the resource and personnel shortages” has been used in this research. Their model helps to predict the resource and personnel shortages during a mass casualty event. In this paper, to deal with the shortages, some temporary emergency operation centers near the hospitals have been created, and extra patients have been allocated to the operation center nearest to the hospitals with the purpose of improving the performance of the hospitals, reducing congestion in the hospitals and considering the welfare of the applicants.

Design/methodology/approach
The authors research will focus on where to locate health-care facilities and how to allocate the patients to multiple hospitals to take into view that in some cases of emergency situations, the patients may exceed the resource and personnel capacity of hospitals to provide conventional standards of care.

Findings
In view of the fact that the problem is high degree of complexity, two multi-objective meta-heuristic algorithms, including non-dominated sorting genetic algorithm (NSGA-II) and non-dominated ranking genetic algorithm (NRGA), were proposed to solve the model where their performances were compared in terms of four multi-objective metrics including maximum spread index (MSI), spacing (S), number of Pareto solution (NPS) and CPU run-time values. For comparison purpose, paired t-test was used. The results of 15 numerical examples showed that there is no significant difference based on MSI, S and NPS metrics, and NRGA significantly works better than NSGA-II in terms of CPU time, and the technique for the order of preference by similarity to ideal solution results showed that NRGA is a better procedure than NSGA-II.

Research limitations/implications
The planning horizon and time variable have not been considered in the model, for example, the length of patients’ hospitalization at hospitals.

Practical implications
Presenting an effective strategy to respond to a mass casualty event (natural and man-made) is the main goal of the authors’ research.

Social implications
This paper strategy is used in all of the health-care centers, such as hospitals, clinics and emergency centers when dealing with disasters and encountering with the heavy and considerable demands of injured patients and inadequate resources and personnel to provide patients with care.

Originality/value
This paper attempts to shed light onto the formulation and the solution of a three-objective optimization model. The first part of the objective function attempts to maximize the covered population of injured patients, the second objective minimizes the distance between hospitals and temporary emergency operation centers and the third objective minimizes the distance between the warehouses and temporary centers.