Location selection of field hospitals amid COVID-19 considering effectiveness and fairness: A case study of Florida.
Location selection of field hospitals amid COVID-19 considering effectiveness and fairness: A case study of Florida.
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DOI：
10.1016/j.ijdrr.2023.103794
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发表时间：
2023-07
影响因子：
5
通讯作者：
Horner, Mark W.
中科院分区：
文献类型：
--
作者：
Alisan, Onur;Ulak, Mehmet Baran;Ozguven, Eren Erman;Horner, Mark W.
关键词：
自二零二零年以来，全球经历了前所未有的全球健康危机，即COVID-19疫情，对各国的医疗系统造成了巨大负担。在大流行高峰期，重症监护病房（ICU）床位短缺表明了这场斗争中的一个关键弱点。由于容量不足，许多遭受COVID-19影响的人很难获得ICU床位。不幸的是，据观察，许多医院没有足够的ICU病床，而具有ICU能力的医院可能无法为所有人口阶层提供服务。为了纠正这一问题，可以建立野战医院，以提供额外的能力，帮助紧急卫生情况，如流行病;然而，选址是最终为此目的的一个关键决定。因此，我们考虑寻找新的野战医院地点，在一定的旅行时间阈值内满足需求，同时考虑到弱势群体的存在。本文提出了一种多目标数学模型，最大化的最小可达性和最小化的行程时间，结合增强的两步浮动集水区（E2 SFCA）方法和行程时间约束的能力限制的p-中位数模型。这是为了决定野战医院的地点，而敏感性分析则涉及医院的能力、需求水平和野战医院地点的数量。在佛罗里达的四个县被选中实施所提出的方法。调查结果可用于确定扩大能力的理想地点，以便在无障碍方面公平分配野战医院，并特别关注人口中的弱势阶层。
The world has experienced an unprecedented global health crisis since 2020, the COVID-19 pandemic, which inflicted massive burdens on countries' healthcare systems. During the peaks of the pandemic, the shortages of intensive care unit (ICU) beds illustrated a critical vulnerability in the fight. Many individuals suffering the effects of COVID-19 had difficulty accessing ICU beds due to insufficient capacity. Unfortunately, it has been observed that many hospitals do not have enough ICU beds, and the ones with ICU capacity might not be accessible to all population strata. To remedy this going forward, field hospitals could be established to provide additional capacity in helping emergency health situations such as pandemics; however, location selection is a crucial decision ultimately for this purpose. As such, we consider finding new field hospital locations to serve the demand within certain travel-time thresholds, while accounting for the presence of vulnerable populations. A multi-objective mathematical model is proposed in this paper that maximizes the minimum accessibility and minimizes the travel time by integrating the Enhanced 2-Step Floating Catchment Area (E2SFCA) method and travel-time-constrained capacitated p-median model. This is performed to decide on the locations of field hospitals, while a sensitivity analysis addresses hospital capacity, demand level, and the number of field hospital locations. Four counties in Florida are selected to implement the proposed approach. Findings can be used to identify the ideal location(s) of capacity expansions concerning the fair distribution of field hospitals in terms of accessibility with a specific focus on vulnerable strata of the population.
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