Quantification of Disaster Resilience of Health Care Facilities

Keywords: Health care facilities.  Disaster resiliency.  Hospital networks.  Quantitative evaluation.  Health-care facilities.  Recovery paths.  Fragility functions.  Analytical metamodels.  Damage.  Natural disasters.  Decision makers.  Emergency preparedness.  Restoration.

Abstract: This report presents concepts of disaster resilience of constructed infrastructure and proposes a methodology for its quantitative evaluation. A unified terminology framework is proposed and implemented for resilience evaluation of health care facilities subjected to earthquakes. The evaluation of disaster resilience is based on non-dimensional analytical functions describing variations of functionality that consider direct and indirect losses and the recovery path. The recovery path is estimated by using either simplified recovery functions or complex organizational and socio-political models. Due to the uncertain nature of structural behavior and functional limit states, hospital losses are described in terms of fragility functions. The framework for resilience quantification is formulated and exemplified for an existing medical facility and a hospital network. In addition, an organizational model describing the functionality of the emergency service of a hospital is developed and implemented. A hybrid simulation and analytical metamodel is developed to estimate, in real time, the hospital functional capacity and its dynamic response, accounting for the influence of structural and nonstructural physical damage on the hospital organization. The proposed metamodel covers a range of hospital configurations, taking into account hospital resources, operational efficiency and possible existence of an emergency plan, maximum capacity, and behavior in saturated and over-capacity conditions. The sensitivity of the metamodel to variations of these parameters is also investigated. Finally, a hospital network is modeled to study the effects on disaster resilience of collaborative operations of health care facilities. The damage to the network, the patients’ transportation time, and the distance among facilities are also considered in the model. The proposed resilience framework captures the effects of disasters, and the effects of preparedness and restoration, and therefore, constitutes a valuable tool for decision makers, designers, and engineering practitioners.