Improving coverage and equity in ambulance planning at the tactical and operational levels: A data-driven optimization model

Ambulance planning in Emergency Medical Services (EMS) has traditionally focused on ensuring coverage. However, incorporating equity into planning has become increasingly important to ensure fair resource distribution across different areas. To this end, this paper develops a decision support system, D ata- D riven E quitable O ptimization M odeling (D-DEOM), designed to improve equity in ambulance planning by leveraging EMS data while guaranteeing coverage, and the EMS resources characteristics. D-DEOM contributes to practice by integrating both horizontal and vertical equity perspectives, enabling decision-makers to develop tailored plans based on different equity perspectives and empirical knowledge. Traditional static allocation methods fail to account for the dynamic nature of EMS demand, which varies spatially and temporally. We address this issue with planned relocations based on spatio-temporal demand forecasting. Our system utilizes a newly developed mixed-integer linear programming (MILP) model for the Ambulance Location and Relocation Problems (ALRP), considering base capacities, limited staffing, heterogeneous fleet, and planned relocations. We demonstrate the applicability of D-DEOM using data from the Portuguese EMS provider (INEM), showing that the dynamic location of ambulances combined with an ambulance time-sharing approach, regulated by different equity perspectives, significantly improves both coverage and equity compared to traditional static methods. Ultimately, this work provides a comprehensive framework for EMS planners to make informed decisions, optimizing ambulance planning while delivering an equitable and efficient service. • Proposes an innovative data-driven optimization approach for ambulance planning. • Incorporates equity in ambulance planning in view of staff and population. • Incorporates the decision-maker’s work experience in the problem solution. • Demonstrates that relocating ambulances does not result in a linear benefit. • Analyzes value added from different perspectives of equity in resource allocation.