title: An Agent-Based Model for Addressing the Impact of a Disaster on Access to Primary Care Services.
abstract: Hurricane Sandy in the Rockaways, Queens, forced residents to evacuate and primary care providers to close or curtail operations. A large deficit in primary care access was apparent in the immediate aftermath of the storm. Our objective was to build a computational model to aid responders in planning to situate primary care services in a disaster-affected area.
  
  
  
  Using an agent-based modeling platform, HAZEL, we simulated the Rockaways population, its evacuation behavior, and primary care providers' availability in the aftermath of Hurricane Sandy. Data sources for this model included post-storm and community health surveys from New York City, a survey of the Rockaways primary care providers, and research literature. The model then tested geospatially specific interventions to address storm-related access deficits.
  
  
  
  The model revealed that areas of high primary care access deficit were concentrated in the eastern part of the Rockaways. Placing mobile health clinics in the most populous census tracts reduced the access deficit significantly, whereas increasing providers' capacity by 50% reduced the deficit to a lesser degree.
  
  
  
  An agent-based model may be a useful tool to have in place so that policy makers can conduct scenario-based analyses to plan interventions optimally in the event of a disaster. (Disaster Med Public Health Preparedness. 2016;10:386-393).
authors.affiliation: 1Department of Health Policy and Management,Graduate School of Public Health,University of Pittsburgh,Pittsburgh,Pennsylvania.
authors.forename: Hasan
authors.initials: H
authors.lastname: Guclu
authors.affiliation: 2Department of Behavioral and Community Health Sciences,Graduate School of Public Health,University of Pittsburgh,Pittsburgh,Pennsylvania.
authors.forename: Supriya
authors.initials: S
authors.lastname: Kumar
authors.affiliation: 3Public Health Dynamics Laboratory,Graduate School of Public Health,University of Pittsburgh,Pittsburgh,Pennsylvania.
authors.forename: David
authors.initials: D
authors.lastname: Galloway
authors.affiliation: 3Public Health Dynamics Laboratory,Graduate School of Public Health,University of Pittsburgh,Pittsburgh,Pennsylvania.
authors.forename: Mary
authors.initials: M
authors.lastname: Krauland
authors.affiliation: 5Bureau of Primary Care Access and Planning,New York City Department of Health and Mental Hygiene,New York,New York.
authors.forename: Rishi
authors.initials: R
authors.lastname: Sood
authors.affiliation: 5Bureau of Primary Care Access and Planning,New York City Department of Health and Mental Hygiene,New York,New York.
authors.forename: Angelica
authors.initials: A
authors.lastname: Bocour
authors.affiliation: 1Department of Health Policy and Management,Graduate School of Public Health,University of Pittsburgh,Pittsburgh,Pennsylvania.
authors.forename: Tina Batra
authors.initials: TB
authors.lastname: Hershey
authors.affiliation: 1Department of Health Policy and Management,Graduate School of Public Health,University of Pittsburgh,Pittsburgh,Pennsylvania.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: van Nostrand
authors.affiliation: 1Department of Health Policy and Management,Graduate School of Public Health,University of Pittsburgh,Pittsburgh,Pennsylvania.
authors.forename: Margaret
authors.initials: M
authors.lastname: Potter
mesh_terms: D003198:Computer Simulation; D055867:Cyclonic Storms; D062489:Health Impact Assessment / Q000295:instrumentation / Q000379:methods*; D006297:Health Services Accessibility / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D009519:New York City; D011320:Primary Health Care / Q000706:statistics & numerical data*
keywords: Superstorm Sandy; agent-based model; hurricane; planning; primary care access; spatial