Cetinkale Zeynep, Aydin Nezir
Turkish Airlines, İstanbul, Turkey.
Department of Industrial Engineering, Yildiz Technical University, Istanbul, Turkey.
Transp Res Rec. 2023 Apr;2677(4):674-703. doi: 10.1177/03611981221099015. Epub 2022 Jun 15.
Health care systems throughout the world are under pressure as a result of COVID-19. It is over two years since the first case was announced in China and health care providers are continuing to struggle with this fatal infectious disease in intensive care units and inpatient wards. Meanwhile, the burden of postponed routine medical procedures has become greater as the pandemic has progressed. We believe that establishing separate health care institutions for infected and non-infected patients would provide safer and better quality health care services. The aim of this study is to find the appropriate number and location of dedicated health care institutions which would only treat individuals infected by a pandemic during an outbreak. For this purpose, a decision-making framework including two multi-objective mixed-integer programming models is developed. At the strategic level, the locations of designated pandemic hospitals are optimized. At the tactical level, we determine the locations and operation durations of temporary isolation centers which treat mildly and moderately symptomatic patients. The developed framework provides assessments of the distance that infected patients travel, the routine medical services expected to be disrupted, two-way distances between new facilities (designated pandemic hospitals and isolation centers), and the infection risk in the population. To demonstrate the applicability of the suggested models, we perform a case study for the European side of Istanbul. In the base case, seven designated pandemic hospitals and four isolation centers are established. In sensitivity analyses, 23 cases are analyzed and compared to provide support to decision makers.
由于新冠疫情，世界各地的医疗系统都面临着压力。自中国宣布首例病例以来，已经过去了两年多，医疗服务提供者仍在重症监护病房和住院病房中与这种致命的传染病作斗争。与此同时，随着疫情的发展，推迟常规医疗程序的负担变得更大。我们认为，为感染患者和未感染患者建立单独的医疗机构将提供更安全、质量更高的医疗服务。本研究的目的是找出专门的医疗机构的合适数量和地点，这些机构在疫情爆发期间只治疗受大流行病感染的个人。为此，开发了一个包括两个多目标混合整数规划模型的决策框架。在战略层面，优化指定大流行医院的位置。在战术层面，我们确定治疗轻症和中症患者的临时隔离中心的位置和运营持续时间。所开发的框架评估了感染患者的出行距离、预计会受到干扰的常规医疗服务、新设施（指定大流行医院和隔离中心）之间的双向距离以及人群中的感染风险。为了证明所建议模型的适用性，我们对伊斯坦布尔欧洲部分进行了案例研究。在基准案例中，建立了七家指定大流行医院和四个隔离中心。在敏感性分析中，分析并比较了23个案例，为决策者提供支持。
