Sharif Journal of Industrial Engineering & Management

Sharif Journal of Industrial Engineering & Management

A Multi-Objective Model for Environmentally Sustainable Healthcare Facility Location-Allocation: Child Cancer Hospitals Establishment in Iran in 2030

Document Type : Article

Authors
Mohammad Fattahi
Arash Nemati
Department of Industrial Engineering, Babol Noshirvani University of Technology, Babol, Iran
Abstract
An unbalanced healthcare facility system causes patients to travel between areas to reach qualified treatment resources, resulting in patient fatigue, unnecessary expenses, delays in disease diagnosis and treatment, and environmental destruction due to CO2 emissions. The environmentally sustainable healthcare facility location-allocation problem focusing on minimizing the carbon footprint resulting from patients’ movement has not been considered. Cancer hospitals provide cancer patients with comprehensive treatment services helpful for avoiding cancer patients referring to different healthcare centers. Child cancer hospitals with a child-centered design can facilitate the cancer disease curing period for children. Although cancer hospital network design has been noticed in recent years, the child cancer hospital location- allocation problem has received no attention. This paper contributes to the environmentally sustainable healthcare facility location-allocation problem by introducing a multi-objective, mixed-integer linear mathematical model to minimize hospital establishment costs, surplus established beds, and the carbon footprint effect for child cancer hospitals'' network design. The newly developed model is solved in a case study to propose a child cancer network establishment for Iran in 2030 using the CPLEX solver due to the significant shortage of specialized cancer treatment capacities in cancer hospitals, particularly those for children. The results indicated the necessity of establishing new child cancer hospitals in 9 provinces, with the highest number of new beds required in Isfahan province and existing beds in Tehran province. The validation of the carbon footprint effect demonstrates that reducing the carbon footprint could lead to a 50% decrease in CO2 emissions. Additionally, the sensitivity analysis reveals that overlooking certain cost and efficiency factors could significantly reduce the carbon footprint effect, highlighting the potential for improved healthcare equity in cancer treatment by reducing the need for child cancer patients and their families to travel between provinces. In addition, several managerial insights and recommendations for future research are proposed.
Keywords
Sustainability
healthcare facility location-allocation
child cancer hospital
carbon footprint effect
hospital capacity planning
Subjects
 
1.    Shekarian, E., Ijadi, B., Zare, A. and Majava, J., 2022. Sustainable supply chain management: A comprehensive systematic review of industrial practices. Sustainability, 14.13 (13), pp.7892.https://doi.org/10.3390/su14137892
2.    Rabbani, M., Hosseini-Mokhallesun, S.A.A., Ordibazar, A.H. and Farrokhi-Asl, H., 2020. A hybrid robust possibilistic approach for a sustainable supply chain location-allocation network design. International Journal of Systems Science: Operations & Logistics, 7.1 (1), pp.60-75.https://doi.org/10.1080/23302674.2018.1506061
3.    Brandenburg, M., Govindan, K., Sarkis, J. and Seuring, S., 2014. Quantitative models for sustainable supply chain management: Developments and directions. European Journal of Operational Research, 233.2 (2), pp.299-312.
https://doi.org/10.1016/j.ejor.2013.09.032
4.    Littlejohns, P., Kieslich, K., Weale, A., Tumilty, E., Richardson, G., Stokes, T., Gauld, R. and Scuffham, P., 2019. Creating sustainable health care systems: Agreeing social (societal) priorities through public participation. Journal of Health Organization and Management, 33.1 (1), pp.18-34.https://doi.org/10.1108/JHOM-02-2018-0065
5.    Mehra, R. and Sharma, M.K., 2021. Measures of sustainability in healthcare. Sustainability Analytics and Modeling, 1.1 (1), pp.100001.https://doi.org/10.1016/j.samod.2021.100001
6.    Wu, F., Chen, W., Lin, L., Ren, X. and Qu, Y., 2022. The balanced allocation of medical and health resources in urban areas of China from the perspective of sustainable development: A case study of Nanjing. Sustainability, 14.11 (11), pp.6707.https://doi.org/10.3390/su14116707
7.    Salami, A., Afshar-Nadjafi, B. and Amiri, M., 2023. A two-stage optimization approach for healthcare facility location-allocation problems with service delivering based on genetic algorithm. International Journal of Public Health, 68, pp.1605015.https://doi.org/10.3389/ijph.2023.1605015
8.    Alinaghian, M., Hejazi, S.R., Bajoul, N. and Sadeghi Velni, K., 2023. A novel robust model for location-allocation of healthcare facilities considering pre-disaster and post-disaster characteristics. Scientia Iranica, 30.2 (2), pp.619-641.https://doi.org/10.24200/sci.2021.5743.1459
9.    Haghshenas, M., Nemati, A. and Asadi-Gangraj, E., 2021. A bi-objective model for cancer hospitals’ location and cancer patients’ allocation in Iran. International Journal of Hospital Research, 10.1 (1), pp.1-12.
10. Mendoza-Gómez, R. and Ríos-Mercado, R.Z., 2022. Location of primary health care centers for demand coverage of complementary services. Computers & Industrial Engineering, 169, pp.108237.
https://doi.org/10.1016/j.cie.2022.108237
11. Karasakal, O., Karasakal, E. and Töreyen, Ö., 2023. A partial coverage hierarchical location-allocation model for health services. European Journal of Industrial Engineering, 17.1 (1), pp.115-147.
https://doi.org/10.1504/EJIE.2023.127742
12. Halawa, F., Madathil, S.C., Gittler, A. and Khasawneh, M.T., 2020. Advancing evidence-based healthcare facility design: A systematic literature review. Health Care Management Science, 23.3 (3), pp.453-480.
https://doi.org/10.1007/s10729-020-09506-4
13. Costa Filho, C.F.F., Rocha, D.A.R., Costa, M.G.F. and De Albuquerque Pereira, W.C., 2012. Using constraint satisfaction problem approach to solve human resource allocation problems in cooperative health services. Expert Systems with Applications, 39.1 (1), pp.385-394.https://doi.org/10.1016/j.eswa.2011.07.027
14. Comparably, n.d. Salary of cancer specialists [Online]. Available at: https://www.comparably.com/salaries/salaries-for-oncologist [Accessed].
15. FreshBooks, 2021. How much does it cost to build a hospital: Construction cost [Online]. Available at: https://www.freshbooks.com [Accessed].
16. Haghshenas, M., Nemati, A. and Asadi-Gangraj, E., 2023. Cancer-curing supply chain planning with regard to hospital bed-capacity efficiency: A plan for Iran in 2040. International Journal of Services and Operations Management, 45.2 (2), pp.170-186.https://doi.org/10.1504/IJSOM.2023.131495
17. Haghshenas, M., Nemati, A. and Asadi-Gangraj, E., 2024. Using new fuzzy regression aptness and healthcare equity indices in cancer hospitals network design: A fuzzy multi-objective mathematical model. OPSEARCH, 61.1 (1), pp.1-35.https://doi.org/10.1007/s12597-023-00723-3
18. Kordi, A. and Nemati, A., 2024. Simultaneous sensitivity analysis of mixed-integer location-allocation models using machine learning tools: Cancer hospitals’ network design. Operational Research, 24.1 (1), pp.22.
https://doi.org/10.1007/s12351-024-00828-7
19. Gul, M. and Guneri, A.F., 2021. Hospital location selection: A systematic literature review on methodologies and applications. Mathematical Problems in Engineering, 2021, pp.1-22.https://doi.org/10.1155/2021/6682958
20. Mestre, A.M., Oliveira, M.D. and Barbosa-Póvoa, A.P., 2015. Location–allocation approaches for hospital network planning under uncertainty. European Journal of Operational Research, 240.3 (3), pp.791-806.
https://doi.org/10.1016/j.ejor.2014.07.024
21. Beheshtifar, S. and Alimoahmmadi, A., 2015. A multi-objective optimization approach for location-allocation of clinics. International Transactions in Operational Research, 22.2 (2), pp.313-328.
https://doi.org/10.1111/itor.12088
22. Zarrinpoor, N., Fallahnezhad, M.S. and Pishvaee, M.S., 2017. Design of a reliable hierarchical location-allocation model under disruptions for health service networks: A two-stage robust approach. Computers & Industrial Engineering, 109, pp.130-150.https://doi.org/10.1016/j.cie.2017.04.036
23. Maleki Rastaghi, M., Barzinpour, F. and Pishvaee, M., 2018. A multi-objective hierarchical location-allocation model for the healthcare network design considering a referral system. International Journal of Engineering, 31.2 (2), pp.365-373.https://doi.org/10.5829/ije.2018.31.02b.22
24. Wang, L., Shi, H. and Gan, L., 2018. Healthcare facility location-allocation optimization for China’s developing cities utilizing a multi-objective decision support approach. Sustainability, 10.12 (12), pp.4580.
https://doi.org/10.3390/su10124580
25. De Melo Sathler, T., Almeida, J.F., Conceição, S.V., Pinto, L.R. and De Campos, F.C., 2019. Integration of facility location and equipment allocation in health care management. Brazilian Journal of Operations & Production Management, 16.3 (3), pp.513-527.https://doi.org/10.14488/BJOPM.2019.v16.n3.a13
26. Ouyang, R., Faiz, T.I. and Noor-E-Alam, M., 2020. Location-allocation models for healthcare facilities with long-term demand. International Journal of Operational Research, 38.3 (3), pp.295-320.
https://doi.org/10.1504/IJOR.2020.10028558
27. Kamali, A., Sajadi, S.M. and Jolai, F., 2020. Optimising emergency medical centres location with a response-time-decreasing approach using hybrid methods of optimisation and simulation. International Journal of Services and Operations Management, 36.1 (1), pp.72-93.https://doi.org/10.1504/IJSOM.2020.10028456
28. Kaveh, M., Kaveh, M., Mesgari, M.S. and Paland, R.S., 2020. Multiple criteria decision-making for hospital location-allocation based on improved genetic algorithm. Applied Geomatics, 12.3 (3), pp.291-306.
https://doi.org/10.1007/s12518-020-00297-5
29. Mishra, S., Sahu, P.K., Sarkar, A.K., Mehran, B. and Sharma, S., 2019. Geo-spatial site suitability analysis for development of health care units in rural India: Effects on habitation accessibility, facility utilization and zonal equity in facility distribution. Journal of Transport Geography, 78, pp.135-149.https://doi.org/10.1016/j.jtrangeo.2019.05.017
Sharif Journal of Industrial Engineering & Management
Volume 41, Issue 2 - Serial Number 2
February 2026
Pages 19-29