Governments must consider different issues when deciding on the location of healthcare centers. In addition to the costs of opening such centers, three further elements should be addressed: accessibility, demand, and equity. Such locations must be chosen to meet the corresponding demand, so that they guarantee a socially equitable distribution, and to ensure that they are accessible to a sufficient degree. The location of the centers must be chosen from a set of possible facilities to guarantee certain minimum standards for the operational viability of the centers. Since the set of potential locations does not necessarily cover the demand of all geographical zones, the efficiency criterion must be maximized. However, the efficient distribution of resources does not necessarily meet the equity criterion. Thus, decision-makers must consider the trade-off between these two criteria: efficiency and equity. The described problem corresponds to the challenge that governments face in seeking to minimize the impact of the pandemic on citizens, where healthcare centers may be either public hospitals that care for COVID-19 patients or vaccination points. In this paper, we focus on the problem of a zone-divided region requiring the localization of healthcare centers. We propose a non-linear programming model to solve this problem based on a coverage formula using the Gini index to measure equity and accessibility. Then, we consider an approach using epsilon constraints that makes this problem solvable with mixed integer linear computations at each iteration. A simulation algorithm is also considered to generate problem instances, while computational experiments are carried out to show the potential use of the proposed mathematical programming model. The results show that the spatial distribution influences the coverage level of the healthcare system. Nevertheless, this distribution does not reduce inequity at accessible healthcare centers, as the distribution of the supply of health centers must be incorporated into the decision-making process.

Governments have been challenged to provide timely medical care to face the COVID-19 pandemic. Under this pandemic, the demand for pharmaceutical products has changed significantly. Some of these products are in high demand, while, for others, their demand falls sharply. These changes in the random demand patterns are connected with changes in the skewness (asymmetry) and kurtosis of their data distribution. Such changes are critical to determining optimal lots and inventory costs. The lot-size model helps to make decisions based on probabilistic demand when calculating the optimal costs of supply using two-stage stochastic programming. The objective of this study is to evaluate how the skewness and kurtosis of the distribution of demand data, collected through sensors, affect the modeling of inventories of hospital pharmacy products helpful to treat COVID-19. The use of stochastic programming allows us to obtain results under demand uncertainty that are closer to reality. We carry out a simulation study to evaluate the performance of our methodology under different demand scenarios with diverse degrees of skewness and kurtosis. A case study in the field of hospital pharmacy with sensor-related COVID-19 data is also provided. An algorithm that permits us to use sensors when submitting requests for supplying pharmaceutical products in the hospital treatment of COVID-19 is designed. We show that the coefficients of skewness and kurtosis impact the total costs of inventory that involve order, purchase, holding, and shortage. We conclude that the asymmetry and kurtosis of the demand statistical distribution do not seem to affect the first-stage lot-size decisions. However, demand patterns with high positive skewness are related to significant increases in expected inventories on hand and shortage, increasing the costs of second-stage decisions. Thus, demand distributions that are highly asymmetrical to the right and leptokurtic favor high total costs in probabilistic lot-size systems.

The objective of this paper is to propose a lot-sizing methodology for an inventory system that faces time-dependent random demands and that seeks to minimize total cost as a function of order, purchase, holding and shortage costs. A two-stage stochastic programming framework is derived to optimize lot-sizing decisions over a time horizon. To this end, we simulate a demand time-series by using a generalized autoregressive moving average structure. The modeling includes covariates of the demand, which are used as predictors of this. We describe an algorithm that summarizes the methodology and we discuss its computational framework. A case study with unpublished real-world data is presented to illustrate the potential of this methodology. We report that the accuracy of the demand variance estimator improves when a temporal structure is considered, instead of assuming time-independent demand. The methodology is useful in decisions related to inventory logistics management when the demand shows patterns of temporal dependence.

Determining success factors for managing supply chains is a relevant aspect for companies. Then, modeling the relationship between inventory cost savings and supply chain success factors is a route for stating such a determination. This is particularly important in pharmacies and food nutrition services (FNS), where the advances made on this topic are still scarce. In this article, we propose and formulate a robust compromise (RoCo) multi-criteria model based on non-linear programming and time-dependent demand. The novelty of our proposal is in defining a score that allows us to measure the mentioned success factors in a simple way, in meeting together all three elements (RoCo multi-criteria, non-linear programming, and time-dependent demand) to state a new model, and in applying it to pharmacies and FNS. This model relates inventory cost savings for pharmacy/FNS and success factors across their supply chains. Savings of inventory costs are predicted by lot sizes to be purchased and computed by comparing optimal and true inventory costs. We utilize a system that records the movements and costs of products to collect the data. Factors, such as purchasing organization, economies of scale, and synchronized supply, are assumed using the purchase system, with these factors ranked on a Likert scale. We consider multilevel relationships between savings obtained for 79 pharmacy/FNS products, and success factor scores according to these products. To deal with the endogeneity bias of the relationships proposed, internal instrumental variables are employed by utilizing generalized statistical moments. Among our main conclusions, we state that the greatest cost savings obtained from inventory models are directly associated with low-success supply chain factors. In this association, the success factors operate as endogenous variables, with respect to inventory cost savings, given the simultaneity of their relationship with cost savings when inventory decision-making.