Optimization techniques applied to the efficient choice of family groups for coordinated care modality.

This study presents a proposal to address group selection problems in the allocation of beneficiaries for the Primary Health Care (PHC) program in a health insurance company. The proposed approach utilizes mathematical modeling based on the classical knapsack problem to optimize the allocation of beneficiaries, considering clinical and individual criteria and the family context. The results were validated with the assistance of a healthcare professional, ensuring the adequacy and relevance of the proposed solutions. The results were compared with greedy methods, which companies commonly use. The proposed solution proved to be more effective by efficiently balancing the objectives of the insurance company, thereby improving operational efficiency and the quality of services offered to the clients of the APS program.