EAPSI: Quantifying the effect of centralization on the resilience of the regional healthcare system in the 2010-11 Canterbury earthquake sequence

EAPSI：量化 2010-11 坎特伯雷地震序列中集中化对区域医疗系统复原力的影响

• 批准号: 1414903
• 负责人: Caitlin Jacques
• 金额: $ 0.51万
• 依托单位: Jacques Caitlin C
• 依托单位国家: 美国
• 项目类别: Fellowship Award
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-01 至 2015-05-31
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=1414903&HistoricalAwards=false
• 关键词: EAPSI; Quantifying; effect; centralization; resilience

Healthcare systems have been identified worldwide as critical infrastructure that must remain functional for communities to effectively respond to disasters such as earthquakes. Much disaster resilience research has assumed that system-wide functionality can be predicted from the performance of independent hospitals. Healthcare, however, functions as a networked system of providers and facilities, rather than a set of independent entities. Therefore, to better understand healthcare delivery after a disaster, it is important to capture the contributions and interactions of all parts of the system. This study will apply engineering techniques for analyzing complex systems to a resilience-based framework in order to characterize healthcare at a system level. This framework will be used to determine the effect of centralization on overall healthcare system performance following seismic events. The Canterbury region, which sustained severe damage in the 2010-2011 Canterbury Earthquake Sequence, provides a unique opportunity to study a highly centralized healthcare system recovering from a series of devastating earthquakes. This work will be performed in collaboration with Dr. Sonia Giovinazzi and the University of Canterbury in New Zealand.The healthcare system will be characterized through interviews with administrators, engineers, and healthcare providers. Emphasis will be placed on how organizations within the system allocate resources needed to create surge capacity, such as space (including infrastructure), staff, and supplies. This study will also examine how resource allocation changed after the earthquakes. Fault-tree analysis will be applied to connect the high-level functionality of the healthcare system (e.g., ability to provide surgery) with base-level performance of resources (e.g. loss of sewage) under four conditions: decentralized pre-earthquake, centralized pre-earthquake, decentralized post-earthquake, and centralized post-earthquake. Resilience under each condition will be calculated for scenario events using functions-based resilience metrics developed for this study. This NSF EAPSI award is funded in collaboration with the Royal Society of New Zealand.

医疗保健系统已被世界各地确定为关键基础设施，必须保持社区有效应对地震等灾害的功能。许多抗灾研究都假设，可以从独立医院的表现中预测整个系统的功能。然而，医疗保健是一个由提供者和设施组成的网络系统，而不是一组独立的实体。因此，为了更好地了解灾难后的医疗服务，重要的是要捕捉系统所有部分的贡献和相互作用。这项研究将应用工程技术分析复杂系统的一个基于约束力的框架，以表征医疗保健系统的水平。该框架将用于确定地震事件发生后集中化对整体医疗保健系统性能的影响。在2010-2011年坎特伯雷地震序列中遭受严重破坏的坎特伯雷地区为研究从一系列毁灭性地震中恢复的高度集中的医疗保健系统提供了一个独特的机会。这项工作将与Sonia Giovinazzi博士和新西兰坎特伯雷大学合作进行。医疗保健系统将通过与管理人员，工程师和医疗保健提供者的访谈来描述。重点将放在系统内各组织如何分配建立快速部署能力所需的资源，如空间（包括基础设施）、工作人员和用品。这项研究还将探讨地震后资源分配的变化。将应用故障树分析来连接医疗保健系统的高级功能（例如，提供手术的能力）与基础水平的资源性能（如污水损失）在四种情况下：分散的震前，集中的震前，分散的震后，集中的震后。将使用为本研究开发的基于功能的弹性指标计算情景事件在每种条件下的弹性。这个NSF EAPSI奖是与新西兰皇家学会合作资助的。