This dissertation considers the importance of optimizing deployed military medical evacuation (MEDEVAC) systems and utilizes operations research techniques to develop models that allow military medical planners to analyze different strategies regarding the management of MEDEVAC assets in a deployed environment. For optimization models relating to selected subproblems of the MEDEVAC enterprise, the work herein leverages integer programming, multi-objective optimization, Markov decision processes, approximate dynamic programming, and machine learning, as appropriate, to identify relevant insights for aerial MEDEVAC operations.
major focus of the Military Health System is to provide efficient and timely medical evacuation (MEDEVAC) to battlefield casualties. Medical planners are responsible for developing dispatching policies that dictate how aerial military MEDEVAC units are utilized during major combat operations. The objective of this research is to determine how to optimally dispatch MEDEVAC units in response to 9-line MEDEVAC requests to maximize MEDEVAC system performance. A discounted, infinite horizon Markov decision process (MDP) model is developed to examine the MEDEVAC dispatching problem. The MDP model allows the dispatching authority to accept, reject, or queue incoming requests based on the request's classification (i.e., zone and precedence level) and the state of the MEDEVAC system. Rejected requests are rerouted to be serviced by other, non-medical military organizations in theater. Performance is measured in terms of casualty survivability rather than a response time threshold since survival probability more accurately represents casualty outcomes. A representative planning scenario based on contingency operations in southern Afghanistan is utilized to investigate the differences between the optimal dispatching policy and three practitioner-friendly myopic baseline policies. Two computational experiments, a two-level, five-factor screening design and a subsequent three-level, three-factor full factorial design, are conducted to examine the impact of selected MEDEVAC problem features on the optimal policy and the system level performance measure. Results indicate that dispatching the closest available MEDEVAC unit is not always optimal and that dispatching MEDEVAC units considering the precedence level of requests and the locations of busy MEDEVAC units increases the performance of the MEDEVAC system. These results inform the development and implementation of MEDEVAC tactics, techniques, and procedures by military medical planners. Moreover, an open question exists concerning the best exact solution approach for solving Markov decision problems due to recent advances in performance by commercial linear programming (LP) solvers. An analysis of solution approaches for the MEDEVAC dispatching problem reveals that the policy iteration algorithm substantially outperforms the LP algorithms executed by CPLEX 12.6 in regards to computational effort. This result supports the claim that policy iteration remains the superlative solution algorithm for exactly solving computationally tractable Markov decision problems.
Military medical planners must develop dispatching policies that dictate how aerial medical evacuation (MEDEVAC) units are utilized during major combat operations. The objective of this research is to determine how to optimally dispatch MEDEVAC units in response to 9-line MEDEVAC requests to maximize MEDEVAC system performance. A discounted, infinite horizon Markov decision process (MDP) model is developed to examine the MEDEVAC dispatching problem. The MDP model allows the dispatching authority to accept, reject, or queue incoming requests based on a request's classification (i.e., zone and precedence level) and the state of the MEDEVAC system. A representative planning scenario based on contingency operations in southern Afghanistan is utilized to investigate the differences between the optimal dispatching policy and three practitioner-friendly myopic policies. Two computational experiments are conducted to examine the impact of selected MEDEVAC problem features on the optimal policy and the system performance measure. Several excursions are examined to identify how the 9-line MEDEVAC request arrival rate and the MEDEVAC flight speeds impact the optimal dispatching policy. Results indicate that dispatching MEDEVAC units considering the precedence level of requests and the locations of busy MEDEVAC units increases the performance of the MEDEVAC system. These results inform the development and implementation of MEDEVAC tactics, techniques, and procedures by military medical planners. Moreover, an analysis of solution approaches for the MEDEVAC dispatching problem reveals that the policy iteration algorithm substantially outperforms the linear programming algorithms executed by CPLEX 12.6 with regard to computational effort. This result supports the claim that policy iteration remains the superlative solution algorithm for exactly solving computationally tractable Markov decision problems.
