An equity-oriented multi-objective inventory management model for blood banks considering the patient conditions: A real-life case

Document Type : Article


1 Faculty of Industrial and Mechanical Engineering, Qazvin Branch, Islamic Azad University, Qazvin, Iran

2 Department of Industrial Management and Information Technology, Management and Accounting Faculty, Shahid Beheshti University, Tehran, Iran


The absence of systematic disparities in health utilization leads to achieving equity in health. However, equity in delivering healthcare services is always challenging because of financial and medical resource constraints. In this regard, a practical multi-objective mixed-integer linear programming model with priority-differentiated demand classes is presented for cost-effective inventory management of blood products considering health equity. The system deals with multiple substitutable products. There are elective and non-elective demands, which are categorized into three main classes based on medical urgencies. The health objectives are investigated to achieve a desirable health equity level in delivering healthcare services to patients. Moreover, the economic objective is pursued to minimize total costs incurred across managing the inventory without weakening the service level. An effective demand-oriented hybrid heuristic is proposed to issue and allocate the blood for demand satisfaction equitably. A goal programming approach is utilized to find the optimum solution. The applicability of the model is validated through a real case study. Finally, several sensitivity analyses are conducted to gain useful managerial insights. According to the results, the proposed model presents a proper solution by making a reasonable health-economic trade-off. Also, the results illustrate the beneficial improvement in patient care and promoting health equity.


1. Braveman, P. "Health disparities and health equity: concepts and measurement", Annu. Rev. Public Heal., 27, pp. 167-194 (2006).
2. Mousazadeh, M., Torabi, S.A., Pishvaee, M.S., et al. "Accessible, stable, and equitable health service network redesign: A robust mixed possibilistic- flexible approach", Transp. Res. Part E Logist. Transp. Rev., 111, pp. 113-129 (2018).
3. van Roode, T., Pauly, B.M., Marcellus, L., et al. "Values are not enough: qualitative study identifying critical elements for prioritization of health equity in health systems", Int. J. Equity Health, 19(1), pp. 1-13 (2020).
4. Culyer, A.J. "Equity-some theory and its policy  mplications", J. Med. Ethics, 27(4), pp. 275-283 (2001).
5. Braveman, P. and Gruskin, S. "Defining equity in health", J. Epidemiol. Community Heal, 57(4), pp. 254-258 (2003).
6. Beier, F.J. "The management of the supply chain for hospital pharmacies: a focus on inventory management practices", J. Bus. Logist., 16(2), p. 153 (1995).
7. Liu, W., Ke, G.Y., Chen, J., et al. "Scheduling the distribution of blood products: A vendor-managed inventory routing approach", Transp. Res. Part E Logist. Transp. Rev., 140, 101964 (2020).
8. Civelek, I., Karaesmen, I., and Scheller-Wolf, A. "Blood platelet inventory management with protection levels", Eur. J. Oper. Res., 243(3), pp. 826-838 (2015).
9. Derikvand, H., Hajimolana, S.M., Jabbarzadeh, A., et al. "A robust stochastic bi-objective model for blood inventory-distribution management in a blood supply chain", Eur. J. Ind. Eng., 14(3), pp. 369-403 (2020).
10. Cheraghi, S. and Hosseini-Motlagh, S.-M. "Responsive and reliable injured-oriented blood supply chain for disaster relief: a real case study", Ann. Oper. Res., 291(1-2), pp. 129-167 (2020).
11. Pulok, M.H., van Gool, K., Hajizadeh, M., et al. "Measuring horizontal inequity in healthcare utilisation: A review of methodological developments and debates", Eur. J. Heal. Econ., 21(2), pp. 171-180 (2020).
12. Dahlgren, G. "Efficient equity-oriented strategies for health", Bull. World Health Organ., 78, pp. 79-81 (2000).
13. Saha, E. and Ray, P.K. "Inventory Management and Analysis of Pharmaceuticals in a Healthcare System", In Healthcare Systems Management: Methodologies and Applications, Springer, pp. 71-95 (2018).
14. Wilson, K. and Hebert, P.C. "The challenge of an increasingly expensive blood system", Cmaj, 168(9), pp. 1149-1150 (2003).
15. Hosseini-Motlagh, S.-M., Samani, M.R.G., and Homaei, S. "Blood supply chain management: robust optimization, disruption risk, and blood group compatibility (a real-life case)", J. Ambient Intell. Humaniz. Comput., 11(3), pp. 1085-1104 (2020).
16. Najafi, M., Ahmadi, A., and Zolfagharinia, H. "Blood inventory management in hospitals: Considering supply and demand uncertainty and blood transshipment possibility", Oper. Res. Heal. Care, 15, pp. 43-56 (2017).
17. Larimi, N.G., Yaghoubi, S., and Hosseini-Motlagh, S.- M. "Itemized platelet supply chain with lateral transshipment under  uncertainty evaluating inappropriate output in laboratories", Socioecon. Plann. Sci., 68, 100697 (2019).
18. Hosseini-Motlagh, S.-M., Samani, M.R.G., and Cheraghi, S. "Robust and stable  flexible blood supply chain network design under motivational initiatives", Socioecon. Plann. Sci., 70, 100725 (2020).
19. Ezugwu, A.E., Olusanya, M.O., and Govender, P. "Mathematical model formulation and hybrid metaheuristic optimization approach for near-optimal blood assignment in a blood bank system", Expert Syst. Appl., 137, pp. 74-99 (2019).
20. Rajendran, S. and Ravindran, A.R. "Inventory management of platelets along blood supply chain to minimize wastage and shortage", Comput. Ind. Eng., 130, pp. 714-730 (2019).
21. Leaven, L., Ahmmad, K., and Peebles, D. "Inventory management applications for healthcare supply chains", Int. J. Supply Chain Manag, 6, pp. 1-7 (2017).
22. Dillon, M., Oliveira, F., and Abbasi, B. "A twostage stochastic programming model for inventory management in the blood supply chain", Int. J. Prod. Econ., 187, pp. 27-41 (2017).
23. Rajendran, S. and Srinivas, S. "Hybrid ordering policies for platelet inventory management under demand uncertainty", IISE Trans. Healthc. Syst. Eng., 10(2), pp. 113-126 (2020).
24. Dehghani, M. and Abbasi, B. "An age-based lateraltransshipment policy for perishable items", Int. J. Prod. Econ., 198, pp. 93-103 (2018).
25. Clay, N.M., Abbasi, B., Eberhard, A., et al. "On the volatility of blood inventories", Int. Trans. Oper. Res., 25(1), pp. 215-242 (2018).
26. Rajendran, S. and Ravindran, A.R. "Platelet ordering policies at hospitals using stochastic integer programming model and heuristic approaches to reduce wastage", Comput. Ind. Eng., 110, pp. 151-164 (2017).
27. Najafi, M., Ahmadi, A., and Zolfagharinia, H. "Blood inventory management in hospitals: Considering supply and demand uncertainty and blood transshipment possibility", Oper. Res. Heal. Care, 15, pp. 43-56 (2017).
28. Hosseinifard, Z. and Abbasi, B. "The inventory centralization impacts on sustainability of the blood supply chain", Comput. Oper. Res., 89, pp. 206-212 (2018).
29. Abbasi, B. and Hosseinifard, S.Z. "On the issuing policies for perishable items such as red blood cells and platelets in blood service", Decis. Sci., 45(5), pp. 995-1020 (2014).
30. Abdulwahab, U. and Wahab, M.I.M. "Approximate dynamic programming modeling for a typical blood platelet bank", Comput. Ind. Eng., 78, pp. 259-270 (2014).
31. Piraban, A., Guerrero, W.J., and Labadie, N. "Survey on blood supply chain management: Models and methods", Comput. Oper. Res., 112, 104756 (2019).
32. Hosseini-Motlagh, S.-M., Samani, M.R.G., and Homaei, S. "Toward a coordination of inventory and distribution schedules for blood in disasters", Socioecon. Plann. Sci., 72, 100897 (2020).
33. Fontaine, M.J., Chung, Y.T., Rogers, W.M., et al. "Improving platelet supply chains through collaborations between blood centers and transfusion services", Transfusion, 49(10), pp. 2040-2047 (2009).
34. Behera, B.K. and Varma, A. "Microbial products supply chain", In Microbial Biomass Process Technologies and Management, Springer, pp. 215-255 (2017).
35. Sohrabi, M., Zandieh, M., and Nadjafi, B.A. "Dynamic demand-centered process-oriented data model for inventory management of hemovigilance systems", Healthc. Inform. Res., 27(1), pp. 73-81 (2021).
36. Manopiniwes, W. and Irohara, T. "Stochastic optimisation model for integrated decisions on relief supply chains: preparedness for disaster response", Int. J. Prod. Res., 55(4), pp. 979-996 (2017).
37. Gunantara, N. "A review of multi-objective optimization: Methods and its applications", Cogent Eng., 5(1), 1502242 (2018).
38. Mosadegh, H., Khakbazan, E., Salmasnia, A., et al. "A fuzzy multi-objective goal programming model for solving an aggregate production planning problem with uncertainty", Int. J. Inf. Decis. Sci., 9(2), pp. 97-115 (2017).
39. Jones, D. and Tamiz, M. "A review of goal programming", In Multiple Criteria Decision Analysis, Springer, pp. 903-926 (2016).
40. Coello, C.A.C., Lamont, G.B., and Van Veldhuizen, D.A., Evolutionary Algorithms for Solving Multi- Objective Problems, Springer (2007).
41. Osorio, A.F., Brailsford, S.C., Smith, H.K., et al. "Designing the blood supply chain: how much, how and where?", Vox Sang., 113(8), pp. 760-769 (2018).
42. Sarhangian, V., Abouee-Mehrizi, H., Baron, O., et al. "Threshold-based allocation policies for inventory management of red blood cells", Manuf. Serv. Oper. Manag., 20(2), pp. 347-362 (2018).
43. Samani, M.R.G., Hosseini-Motlagh, S.-M., and Ghannadpour, S.F. "A multilateral perspective towards blood network design in an uncertain environment: Methodology and implementation", Comput. Ind. Eng., 130, pp. 450-471 (2019).
44. Uthayakumar, R. and Karuppasamy, S.K. "An EOQ model for deteriorating items with different types of time-varying demand in healthcare industries", J. Anal., 27(1), pp. 3-18 (2019).
45. Paul, A., Rajapakshe, T., and Mallik, S., "Socially optimal contracting between a regional blood bank and hospitals", Prod. Oper. Manag., 28(4), pp. 908-932 (2019).
46. Srinivas, S. and Rajendran, C. "Community detection and influential node identification in complex networks using mathematical programming", Expert Syst. Appl., 135, pp. 296-312 (2019).
47. Attari, M.Y.N. and Abdoli, N. "Reducing wastages and shortages of blood products at hospitals with considering ABO/Rh (D) compatibility", J. Ind. Eng. Decis. Mak., 1(1), pp. 24-48 (2020).