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

Abstract

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.