Yvonne Merino, Luis Ceferino, Sebastian Pizarro, Juan C de la Llera
{"title":"Modeling hospital resources based on global epidemiology after earthquake-related disasters","authors":"Yvonne Merino, Luis Ceferino, Sebastian Pizarro, Juan C de la Llera","doi":"10.1177/87552930241262788","DOIUrl":null,"url":null,"abstract":"Injured people require hospital emergency services and timely medical treatment after extreme earthquakes. Earthquake-related patients often have trauma injuries and stress-linked (ischemic) ailments that require multiple healthcare procedures, such as minor orthopedic treatment, surgical treatment of fractures, and thrombolysis or thrombectomy. Hospital operation models have been proposed to examine these healthcare procedures; however, they exhibit two fundamental gaps that hinder their ability to assess critical service areas after earthquakes. First, these models rest heavily on emergency procedures based on injury severity rather than type. Second, healthcare demands are often modeled from injury profiles after moderate earthquakes in the United States without including epidemiology data after large earthquakes globally. This approach has led to oversimplified hospital emergency services and resource utilization representation. This research presents a new hospital operations model based on patient injury type and worldwide earthquake epidemiology to fill these gaps. We build the model using discrete-event simulations to capture dynamic metrics on hospital operational outcomes after the earthquake, such as patient time-to-treatment and unassisted patient ratio. We then studied how these metrics vary with different levels of functional capacity in the specific hospital resources. Our results showed that waiting times for emergency department (ED)-level patients vary non-linearly with changes in the number of functional service areas. Also, significant reduction in the waiting time for hospital-level procedures was found for relatively small decrease in the bed occupancy rate, for example, if reverse triage procedures are activated (i.e. a discharge of non-critical patients admitted before the earthquake). Our findings provide a valuable tool for decision-making in hospital preparedness as they explicitly measure the impacts of functional capacity on key healthcare metrics for specific earthquake-related patients.","PeriodicalId":11392,"journal":{"name":"Earthquake Spectra","volume":null,"pages":null},"PeriodicalIF":3.1000,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Earthquake Spectra","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1177/87552930241262788","RegionNum":2,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENGINEERING, CIVIL","Score":null,"Total":0}
引用次数: 0
Abstract
Injured people require hospital emergency services and timely medical treatment after extreme earthquakes. Earthquake-related patients often have trauma injuries and stress-linked (ischemic) ailments that require multiple healthcare procedures, such as minor orthopedic treatment, surgical treatment of fractures, and thrombolysis or thrombectomy. Hospital operation models have been proposed to examine these healthcare procedures; however, they exhibit two fundamental gaps that hinder their ability to assess critical service areas after earthquakes. First, these models rest heavily on emergency procedures based on injury severity rather than type. Second, healthcare demands are often modeled from injury profiles after moderate earthquakes in the United States without including epidemiology data after large earthquakes globally. This approach has led to oversimplified hospital emergency services and resource utilization representation. This research presents a new hospital operations model based on patient injury type and worldwide earthquake epidemiology to fill these gaps. We build the model using discrete-event simulations to capture dynamic metrics on hospital operational outcomes after the earthquake, such as patient time-to-treatment and unassisted patient ratio. We then studied how these metrics vary with different levels of functional capacity in the specific hospital resources. Our results showed that waiting times for emergency department (ED)-level patients vary non-linearly with changes in the number of functional service areas. Also, significant reduction in the waiting time for hospital-level procedures was found for relatively small decrease in the bed occupancy rate, for example, if reverse triage procedures are activated (i.e. a discharge of non-critical patients admitted before the earthquake). Our findings provide a valuable tool for decision-making in hospital preparedness as they explicitly measure the impacts of functional capacity on key healthcare metrics for specific earthquake-related patients.
期刊介绍:
Earthquake Spectra, the professional peer-reviewed journal of the Earthquake Engineering Research Institute (EERI), serves as the publication of record for the development of earthquake engineering practice, earthquake codes and regulations, earthquake public policy, and earthquake investigation reports. The journal is published quarterly in both printed and online editions in February, May, August, and November, with additional special edition issues.
EERI established Earthquake Spectra with the purpose of improving the practice of earthquake hazards mitigation, preparedness, and recovery — serving the informational needs of the diverse professionals engaged in earthquake risk reduction: civil, geotechnical, mechanical, and structural engineers; geologists, seismologists, and other earth scientists; architects and city planners; public officials; social scientists; and researchers.