An integrated approach for strategic and tactical decisions for the emergency medical service

Choosing locations for emergency medical service stations and vehicles has been thoroughly investigated. However, the formulations presented to solve this question are not always done in a way that can be applied in practice, because they are based on oversimplified mathematical functions, which makes them unrealistic. The problem persists as integrated strategic and tactical approaches require an analytical complexity that often invalidates the exact solution. This work proposes an integrated strategic and tactical planning decision methodology that complements an optimization model with a local search using a metamodel as a proxy of the real system. This allows empirical evidence to be inferred for vehicle location solutions that improve performance in the real system. The methodology is applied to the city of Porto, and two dilemmas are tested to show proof of application. First, the debate between the integrated versus non-integrated approach is analysed. Second, an assessment of the advantages of adding a vehicle or a station to the planning budget is analysed. The conclusions of this research support the advantages of an integrated approach indicated by other studies. The results also show that adding a new vehicle to the system is more advantageous than adding a new station when it comes to victims' survival. These two application examples provide proof of the methodology applicability and open doors for future research on the subject.