Optimizing Home Care Services is receiving a great attention in Operations Research. We address arrival time consistency, person-oriented consistency and demand uncertainty in Home Care, while jointly optimizing assignment, scheduling and routing decisions over a multiple-day time horizon. Consistent time schedules are very much appreciated by patients who, in this setting, are very sensitive to changes in their daily routines. Also person-oriented consistency positively impacts on service quality, guaranteeing that almost the same set of caregivers take care of a patient in the planning horizon. Demand uncertainty plays a pivotal role, too, since both the set of patients under treatment and their care plan can change over time. To the best of our knowledge, this is the first paper dealing with all these aspects in Home Care via a robust approach. We present a mathematical model to the problem, and a pattern-based algorithmic framework to solve it. The framework is derived from the model via decomposition, i.e. suitably fixing the scheduling decisions through the concept of pattern. We propose alternative policies to generate patterns, taking into account consistency and demand uncertainty; when embedding them in the general framework, alternative pattern based algorithms originate. The results of a rich computational experience show that introducing consistency and demand uncertainty in pattern generation policies is crucial to efficiently compute very good quality solutions, in terms of robustness and balancing of the caregiver workload. In addition, a comparison with a simpler model, where no kind of consistency is imposed, shows the importance of considering consistency in pursuing a valuable patient-centered perspective, with a positive effect also on the efficiency of the solution approach.

优化家庭护理服务在运筹学中受到了极大的关注。我们解决家庭护理中的到达时间一致性、以人为本的一致性和需求不确定性，同时在多天的时间范围内共同优化分配、调度和路由决策。患者非常喜欢一致的时间表，在这种情况下，他们对日常生活的变化非常敏感。此外，以人为本的一致性对服务质量产生积极影响，确保几乎同一组护理人员在计划范围内照顾患者。需求的不确定性也起着关键作用，因为接受治疗的患者及其护理计划都会随着时间而改变。据我们所知，这是第一篇通过稳健的方法处理家庭护理中所有这些方面的论文。我们提出了一个数学模型来解决这个问题，以及一个基于模式的算法框架来解决它。该框架是通过分解从模型导出的，即通过模式的概念适当地固定调度决策。考虑到一致性和需求不确定性，我们提出了生成模式的替代策略；当将它们嵌入到通用框架中时，会产生基于模式的替代算法。丰富的计算经验的结果表明，在模式生成策略中引入一致性和需求不确定性对于有效计算质量非常好的解决方案至关重要，这在健壮性和护理人员工作量的平衡方面是至关重要的。此外，与没有强加任何一致性的更简单模型进行比较，