Designing Sustainable Healthcare Additive Manufacturing Networks Using a Multi-Objective Spatial Routing Framework

<i>Background</i>: This study evaluates an additive manufacturing (AM) network designed to balance economic performance, lead time, and environmental impact within the healthcare logistics and supply chain. <i>Methods</i>: An integrated framework is proposed that identifies optimal AM facility locations using spatial K-means clustering and optimizes delivery routes through a multi-objective vehicle routing problem with time windows (MOVRPTW). This framework was applied to a case study in Phra Nakhon Si Ayutthaya, Thailand, utilizing hospital geocoordinates, demand profiles, and CO₂ emission factors to evaluate centralized versus decentralized network configurations. <i>Results</i>: Findings demonstrate that hub structures derived from K-means clustering achieve the highest economic efficiency, reducing the AM part cost per unit to 698.51 Baht. In contrast, a fully centralized network resulted in a significantly higher unit cost of 4759.79 Baht, while clustering based on hospital types yielded a unit cost of 959.34 Baht. Quantitative results indicate that the multi-objective approach provides a superior trade-off, achieving lead time requirements while maintaining operational costs and emissions. <i>Conclusions</i>: The results indicate that the proposed framework, particularly through spatial clustering, offers a practical decision-support tool for designing AM networks that achieve a balance between operational efficiency and sustainability objectives in healthcare logistics.