ArticlePloS one2021
A challenge for healthcare system resilience after an earthquake: The crowdedness of a first-aid hospital by non-urgent patients.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 19 citations in OpenAlex.
- Nearly two years after the earthquake: the prevalence and determinants of health service delay behavior among earthquake victims living in temporary accommodation centers in Türkiye.BMC public health · 2026Article
- Understanding patient safety during earthquakes: a phenomenological study of disaster response.BMJ quality & safety · 2026Article
- Population shifts during the reconstruction period in areas marked as evacuation zones after the Fukushima Daiichi nuclear power plant accident: a mobile spatial statistics data-based time-series clustering analysis.Journal of radiation research · 2024Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
After a violent earthquake, the supply of medical services may fall short of the rising demand, leading to overcrowding in hospitals, and, consequently, a collapse in the healthcare system. This paper takes the emergency care system in Taiwan as the research context, where first-aid hospitals are ranked to three levels, advanced, intermediate, and general, and, currently, emphasizes on a general emergency responsibility hospital. Having limited capacity and capability, a general emergency responsibility hospital treats minor and moderate injuries, from which the majority of earthquake-induced casualties suffer. The purpose of this study is to analyze the impact of this group of earthquake-induced non-urgent patients on the performance of a hospital. A patient flow model was built to represent patients' paths throughout emergency care. Based on the model, discrete event simulation was applied to simulate patients' trajectories and states of a hospital under four seismic scenarios, where patient visits are 1.4, 1.6, 1.9, and 2.3 times the normal number. A healthcare performance index, Crowdedness Index (CI), is proposed to measure crowdedness on a daily basis, which is defined as the ratio of the average waiting time for treatment to the recommended maximal waiting time. Results of simulations rendered the establishment of empirical equations, describing the relation between the maximum CIs and the patient growth ratios. In the most severe case in this study, the maximum CI exceeds 92 and it takes 10 days to recover from the quality drop. This highlights the problem a general emergency responsibility hospital may encounter if no emergency response measure is implemented. Findings are provided pertaining to the predication of a recovery curve and the alarming level of patient increase, which are supportive information for preparedness planning as well as response measure formulation to improve resilience.
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