New York City's healthcare transportation during a disaster: a preparedness framework for a wicked problem.
During a disaster, victims with varied morbidities are located at incident sites, while healthcare facilities with varied healthcare resources are distributed elsewhere. Transportation serves an essential equilibrating role: it helps balance the patients' need for care with the supply of care. Studying the special case of New York City, this article sets out the healthcare transportation components as: (1) incident morbidity; (2) transportation assets; and (3) healthcare capacity. The relationship between these three components raises an assignment problem: the management of healthcare transportation within a dynamic and partly unpredictable incident-transportation-healthcare nexus, under urban disruption. While the routine dispatch problem can be tackled through better geographic allocation software and technical algorithms, the disaster assignment problem must be confronted through real-time, mutual adjustment between institutions. This article outlines institutional alternatives for managing the assignment problem and calls for further research on the merits of alternative institutional models.
Sternberg
Ernest
E
Department of Urban and Regional Planning, University at Buffalo, State University of New York, Buffalo, New York 14214, USA. ezs@buffalo.edu
Lee
George C
GC
D004189:Disaster Planning; D017598:Efficiency, Organizational; D006801:Humans; D009519:New York City; D014187:Transportation of Patients / Q000458:organization & administration*