Fair-GNE : Generalized Nash Equilibrium-Seeking Fairness in Multiagent Healthcare Automation

Enforcing a fair workload allocation among multiple agents tasked to achieve an objective in learning enabled demand side healthcare worker settings is crucial for consistent and reliable performance at runtime. Existing multi-agent reinforcement learning (MARL) approaches steer fairness by shaping reward through post hoc orchestrations, leaving no certifiable self-enforceable fairness that is immutable by individual agents at runtime. Contextualized within a setting where each agent shares resources with others, we address this shortcoming with a learning enabled optimization scheme among self-interested decision makers whose individual actions affect those of other agents. This extends the problem to a generalized Nash equilibrium (GNE) game-theoretic framework where we steer group policy to a safe and locally efficient equilibrium, so that no agent can improve its utility function by unilaterally changing its decisions. Fair-GNE models MARL as a constrained generalized Nash equilibrium-seeking (GNE) game, prescribing an ideal equitable collective equilibrium within the problem's natural fabric. Our hypothesis is rigorously evaluated in our custom-designed high-fidelity resuscitation simulator. Across all our numerical experiments, Fair-GNE achieves significant improvement in workload balance over fixed-penalty baselines (0.89 vs.\ 0.33 JFI, $p < 0.01$) while maintaining 86\% task success, demonstrating statistically significant fairness gains through adaptive constraint enforcement. Our results communicate our formulations, evaluation metrics, and equilibrium-seeking innovations in large multi-agent learning-based healthcare systems with clarity and principled fairness enforcement.

Skill-Aligned Fairness in Multi-Agent Learning for Collaboration in Healthcare

Fairness in multi-agent reinforcement learning (MARL) is often framed as a workload balance problem, overlooking agent expertise and the structured coordination required in real-world domains. In healthcare, equitable task allocation requires workload balance or expertise alignment to prevent burnout and overuse of highly skilled agents. Workload balance refers to distributing an approximately equal number of subtasks or equalised effort across healthcare workers, regardless of their expertise. We make two contributions to address this problem. First, we propose FairSkillMARL, a framework that defines fairness as the dual objective of workload balance and skill-task alignment. Second, we introduce MARLHospital, a customizable healthcare-inspired environment for modeling team compositions and energy-constrained scheduling impacts on fairness, as no existing simulators are well-suited for this problem. We conducted experiments to compare FairSkillMARL in conjunction with four standard MARL methods, and against two state-of-the-art fairness metrics. Our results suggest that fairness based solely on equal workload might lead to task-skill mismatches and highlight the need for more robust metrics that capture skill-task misalignment. Our work provides tools and a foundation for studying fairness in heterogeneous multi-agent systems where aligning effort with expertise is critical.