Effective plans for hospital system response to earthquake emergencies.

Hospital systems play a critical role in treating injuries during disaster emergency responses. Simultaneously, natural disasters hinder their ability to operate at full capacity. Thus, cities must develop strategies that enable hospitals' effective disaster operations. Here, we present a methodology to evaluate emergency response based on a model that assesses the loss of hospital functions and quantifies multiseverity injuries as a result of earthquake damage. The proposed methodology can design effective plans for patient transfers and allocation of ambulances and mobile operating rooms. This methodology is applied to Lima, Peru, subjected to a disaster scenario following a magnitude 8.0 earthquake. Our results show that the spatial distribution of healthcare demands mismatches the post-earthquake capacities of hospitals, leaving large zones on the periphery significantly underserved. This study demonstrates how plans that leverage hospital-system coordination can address this demand-capacity mismatch, reducing waiting times of critically injured patients by factors larger than two.

Impact on hospital functions following the 2010 Chilean earthquake.

OBJECTIVE: The objective of this study was to assess the impact of the 2010 Chilean earthquake on hospital functions and services. Hospitals functioning in a post-disaster environment must provide emergency medical care related to the event, in addition to providing standard community health services. This study focused on damage to both structural and nonstructural components, as well as to utility services. METHODS: Site visits were made to every hospital in a single province (Bio-Bio). Engineers conducted damage assessments while interviews of hospital administrators were conducted. The survey was requested by the Chilean Ministry of Health (MOH) to assess the impact of the earthquake on hospital operations and facility responses to those effects. Other important regional and hospital data were gathered from hospital administrators and the MOH. RESULTS: Seven government hospitals were surveyed. All hospitals in the region lost communications, municipal electrical power and water for several days. All reported some physical damage although only one suffered significant structural damage. All lost some functional capacity as a result of the earthquake. The loss of telephones and cellular service was identified as the most difficult problem by administrators. An average of 3 physical areas per hospital lost some degree of functional capacity following the earthquake. CONCLUSION: Even in an earthquake-prone and very well-prepared country such as Chile hospital functions were widely disrupted by the event. The loss of hospital functions can occur even with minimal damage to the physical structure. The loss of communications can impede or halt response efforts at all levels. Hospitals should be prepared to self-sustain following a disaster for 2-3 days regardless of the level of structural damage. Understanding the details of these impacts is essential to hospital preparedness and plans for continuing services after a disaster.