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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  and
George C. Lee
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: ezs@buffalo.edu
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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.

Keywords

disasteremergency departmenthealthcarehospitalmobilizationsurgetransportation
Type
Special Report
Information
Prehospital and Disaster Medicine , Volume 24 , Issue 2 , April 2009 , pp. 95 - 107
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2009

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