将风险评估和决策方法整合到菲律宾棉兰老岛达沃市 COVID-19 疫情动态分析中。

Integrating Risk Assessment and Decision-Making Methods in Analyzing the Dynamics of COVID-19 Epidemics in Davao City, Mindanao Island, Philippines.

机构信息

Office for Research, Development and Innovation, Malayan Colleges Mindanao, Davao City, Philippines.

Center for Applied Modeling, Data Analytics, and Bioinformatics for Decision Support Systems in Health, Davao City, Philippines.

出版信息

Risk Anal. 2022 Jan;42(1):105-125. doi: 10.1111/risa.13779. Epub 2021 Jul 16.

Abstract

The COVID-19 pandemic has become a public health crisis in the Philippines and the attention of national and local health authorities is focused on managing the fluctuating COVID-19 cases. This study presents a method that integrates risk management tools into health care decision-making processes to enhance the understanding and utilization of risk-based thinking in public health decision making. The risk assessment consists of the identification of the key risk factors of the COVID-19 contagion via bow-tie diagrams. Second, the safety controls for each risk factor relevant to the Davao City context are taken into account and are identified as barriers in the bow-tie. After which, the prioritization of the identified COVID-19 risks, as well as the effectiveness of the proposed interventions, is performed using the analytic hierarchy process. Consequently, the dynamics of COVID-19 management initiatives were explored using these priorities and a system of ordinary differential equations. Our results show that reducing the number of COVID-19 fatalities should be the top priority of the health authorities. In turn, we predict that the COVID-19 contagion can be controlled and eliminated in Davao city in three-month time after prioritizing the fatalities. In order to reduce the COVID-19 fatalities, health authorities should ensure an adequate number of COVID-ready ICU facilities. The general public, on the other hand, should follow medical and science-based advice and suspected and confirmed COVID-19 patients should strictly follow isolation protocols. Overall, an informed decision-making is necessary to avoid the unwanted consequences of an uncontrolled contagion.

摘要

新冠疫情已成为菲律宾的公共卫生危机,国家和地方卫生当局的注意力集中在管理不断波动的新冠病例上。本研究提出了一种将风险管理工具整合到医疗保健决策过程中的方法,以增强基于风险的思维在公共卫生决策中的理解和利用。风险评估包括通过蝴蝶结图识别新冠传播的关键风险因素。其次,考虑到与达沃市背景相关的每个风险因素的安全控制措施,并将其确定为蝴蝶结中的障碍。之后,使用层次分析法对确定的新冠风险进行优先级排序,并评估拟议干预措施的有效性。因此,使用这些优先级和一个常微分方程组来探索新冠管理措施的动态。我们的研究结果表明,减少新冠死亡人数应成为卫生当局的首要任务。反过来,我们预测,在优先考虑死亡人数后,达沃市的新冠传播可以在三个月内得到控制和消除。为了减少新冠死亡人数,卫生当局应确保有足够数量的新冠重症监护病房设施。另一方面,公众应遵循医学和基于科学的建议,疑似和确诊的新冠患者应严格遵守隔离协议。总之,需要做出明智的决策,以避免不受控制的传播带来的不良后果。

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