Patient flow logistics from disaster to care
a scoping review of actors, transport modes and decision problems
J.M. Magana (TU Delft - Transport and Logistics)
S. Hinrichs-Krapels (TU Delft - Policy Analysis)
W. M. Bramer (Erasmus MC)
M. Comes (TU Delft - Transport and Logistics)
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Abstract
Sudden-onset
disasters impact the health and well-being of millions of people each
year. Typically, a sudden-onset disaster will lead to a surge of
patients that require immediate acute care, even though health
infrastructure and resources may be destroyed or not accessible. The
challenge of patient flow logistics is transporting those in need of
acute care rapidly to locations where they can be treated. The fields
and disciplines tackling these challenges, therefore, span from
disaster-related to health-related logistics, but it is not known
whether and how research and approaches across these fields align. This
study aims to scope this emergent field, identify research gaps and
develop a conceptual framework that bridges the disaster-related and
health-related logistics literature.
This
paper follows a scoping review protocol. The authors screened an
initial 8,491 papers, of which 127 were retained for a full-text review.
Analyzing these papers, the authors map out the key concepts such as
actors, locations, transportation modes and decision problems used in
the literature. The study identifies research gaps and synthesize the
findings into a conceptual framework to guide future research.
This
review identified four gaps in the existing literature: (1) The
literature focuses primarily on earthquakes and terrorist attacks,
limited attention is given to other sudden-onset disaster types despite
their frequency; (2) The literature focuses on formal actors such as
health providers or civil protection bodies, while communities are
largely portrayed as passive patients or victims; (3) Actors are largely
assumed to follow standardized protocols, often ignoring emergent roles
or behavioral changes typical for sudden-onset disasters; (4)
Objectives predominantly relate to either efficiency or effectiveness,
neglecting fairness and multiobjective problems.
To
the best of the authors’ knowledge, this scoping review is the first to
explore the different aspects of patient logistics in sudden-onset
disasters by bridging the disaster-related and health-related
literature.
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