Tesis
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Colección de Tesis y Trabajos de grado (informe final del proyecto de investigación, tesina, u otro trabajo académico diferente a Tesis, sujeto a la revisión y aceptación de una comisión dictaminadora) presentados por alumnos para obtener un grado académico del Tecnológico de Monterrey.
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- Optimal location-allocation of specialized healthcare service across public hospital networks(Instituto Tecnológico y de Estudios Superiores de Monterrey, 2016-01-01) Mendoza Gómez, Rodolfo; MENDOZA GOMEZ, RODOLFO; 378771; Serrato García, Marco Antonio; puemcuervo; Valenzuela Ocaña, Karla Beatriz; School of Engineering and Sciences; Campus Toluca; Ríos Mercado, Roger Z.In this thesis, we propose a location-allocation model for a specialized diagnostic service that requires costly diagnostic equipment such as MRI, CT, PET/CT, and Digital Mammography in a segmented public healthcare system. The aim is to determine which hospitals will provide the service and their capacity levels, the allocation of demand in each institution, and the reallocation of uncovered demand to other institutions or private providers in each period while minimizing the total equivalent annual cost of investment and operating cost required to satisfy all the demand. The capacity levels are based on the number of equipment, and different equipment types are considered. The service is segmented in levels of patient acuity, to identify the degree of severity of the illness. Two variants of the model are also presented, the first one considers levels of specialization of the service instead of urgency demand levels, and the second one is a particular case of the original model when some additional assumptions are met. The proposed mixed-integer linear programming models can be solved by conventional branch-and-bound for relatively small instances. An empirical evaluation to determine solvable instance sizes for each model is carried out. A sensitive analysis is performed to evaluate solution behavior as a function of some key parameters. To cope with large-scale instances, heuristics and metaheuristic methods are proposed and implemented. Two constructive methods are developed. These procedures are embedded into an iterated greedy algorithm that is combined with a variable neighborhood descent algorithm. A greedy randomized adaptive search procedure is additionally developed. This metaheuristic relies on some of the components already developed for the iterated greedy algorithm. In general, good quality results in moderate computation times are found for larger instances using different strategies that combine constructive methods and different neighborhood structures.
- Diseño y aplicación de un modelo de localización asignación para la evaluación del acceso a unidades médicas de primer nivel de la Secretaria de Salud para municipios rurales en el Estado de México(Instituto Tecnológico y de Estudios Superiores de Monterrey, 2012-05-04) Mendoza Gómez, Rodolfo; SERRATO GARCIA, MARCO ANTONIO; 240230; Valenzuela Ocaña, Karla B; emipsanchez; Serrato García, Marco Antonio; Robles Cárdenas, Manuel; Escuela de Ingeniería y Ciencias; Campus Toluca; Ríos Mercado, Roger Z.To face the problems of access to health services in Mexico, the purpose of this work is to present a tool for making decisions regarding the problem of the population proportion with limited access to health services, being more significant in rural areas. Concerning this, the Integrator Model of Health Care of the Health in Mexico is aimed at removing geographical barriers, as well as improving organizational and cultural access to health services through the coordination of health care networks. In this work, in order to improve the formation of these networks, we propose the use of models for allocating the population to different public health facilities and the enlargement or location of new ones when the capacity is insufficient. With information available to Mexico, the models were applied in five rural municipalities in Mexico State. The results were compared with the Operational Regionalization Study of Mexico State in 2001 and the Physical Infrastructure Master Plan in Health for Mexico State in 2010, with a significant reduction in distance traveled by the population, better equitable distribution in the different health facilities, and identification of candidate sites for opening new units were found, maximizing the coverage and improving the level of service.