Department of Production Engineering, Technology Center, University Campus Lagoa Nova, UFRN, Natal, Brazil.
Universidade Potiguar (UnP) Laureate, Natal, Brazil.
Technol Health Care. 2021;29(3):445-456. doi: 10.3233/THC-202579.
The growth of the urban population exerts considerable pressure on municipalities' public managers to focus their attention on providing emergency medical care that meets the growing demand for emergency pre-hospital medical care. Currently, there are a significant number of traffic accidents and other serious occurrences, such as heart attacks, drownings, epidemics, fires and disasters (floods, landslides, earthquakes) that demand a prompt and seamless response from pre-hospital medical care. As a result of such scenario, the present article endeavours to apply a dual-coverage mathematical model (DSM-Double Standard Model) to define the optimal location of the Emergency Medical Service (SAMU) decentralized dispatch bases in Natal/RN and conduct a simulation study to evaluate the displacement of ambulances between such bases.
The methodological course that was followed by this research constitutes of 12 steps. The location of decentralized bases for sending emergency ambulances was established using the DSM model and the simulation model was performed using the FlexSim© software version 2018 evaluating base coverage in relation to the total number of calls by demand points for different scenarios.
The results obtained throughout the research demonstrated the feasibility of redefining the decentralized bases of SAMU/Natal ambulances as a strategy to reduce response time and guarantee compliance with performance parameters established by international organizations (the World Health Organization, for instance, establishes the time of 8 minutes for emergency medical service calls response). The simulation study showed a significant reduction in response time, by up to 60% in some cases.
The proposition of new locations for the decentralized dispatch bases of the SAMU/Natal can provide an overall significant reduction on the ambulance response time, so as to contribute to expedite the initiation of treatment of patients, if necessary, sent to hospitals.
城市人口的增长给市政公共管理者带来了相当大的压力，他们需要关注提供满足日益增长的紧急院前医疗需求的紧急医疗服务。目前，有大量的交通事故和其他严重事件，如心脏病发作、溺水、流行病、火灾和灾害（洪水、山体滑坡、地震），需要院前医疗提供迅速和无缝的响应。由于这种情况，本文旨在应用双重覆盖数学模型（DSM-双重标准模型）来定义纳塔尔/RN 的紧急医疗服务（SAMU）分散调度基地的最佳位置，并进行模拟研究，以评估这些基地之间救护车的转移。
本研究遵循的方法学过程包括 12 个步骤。使用 DSM 模型确定了分散基地的位置，使用 FlexSim©软件版本 2018 执行了模拟模型，评估了不同场景下需求点总呼叫次数与基地覆盖范围之间的关系。
整个研究过程中的结果表明，重新定义 SAMU/Natal 救护车的分散基地是一种可行的策略，可以缩短响应时间，并保证符合国际组织（例如世界卫生组织）制定的绩效参数。模拟研究表明，响应时间显著缩短，在某些情况下可达 60%。
为 SAMU/Natal 的分散调度基地提出新的位置，可以整体显著缩短救护车的响应时间，从而有助于加快送往医院的患者的治疗启动。
