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New York City's Healthcare Transportation during a Disaster: A Preparedness Framework for a Wicked Problem

Published online by Cambridge University Press:  28 June 2012

Ernest Sternberg*
Affiliation:
Department of Urban and Regional Planning, University at Buffalo, State University of New York, Buffalo, New York, USA
George C. Lee
Affiliation:
Department of Civil, Structural, and Environmental Engineering, University at Buffalo, State University of New York, Buffalo, New York, USA
*
Hayes Hall, South Campus Buffalo, NY 14214USA E-mail: [email protected]

Abstract

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.

Type
Special Report
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2009

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