Shoaib Mohd, Mustafee Navonil, Madan Karan, Ramamohan Varun
Department of Mechanical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, 110016, India.
Centre for Simulation, Analytics and Modelling, University of Exeter, Rennes Drive, Exeter, EX4 4ST, UK.
Socioecon Plann Sci. 2023 Jun 24:101660. doi: 10.1016/j.seps.2023.101660.
The COVID-19 pandemic has placed severe demands on healthcare facilities across the world, and in several countries, makeshift COVID-19 centres have been operationalised to handle patient overflow. In developing countries such as India, the public healthcare system (PHS) is organised as a hierarchical network with patient flows from lower-tier primary health centres (PHC) to mid-tier community health centres (CHC) and downstream to district hospitals (DH). In this study, we demonstrate how a network-based modelling and simulation approach utilising generic modelling principles can (a) quantify the extent to which the existing facilities in the PHS can effectively cope with the forecasted COVID-19 caseload; and (b) inform decisions on capacity at makeshift COVID-19 Care Centres (CCC) to handle patient overflows. We apply the approach to an empirical study of a local PHS comprising ten PHCs, three CHCs, one DH and one makeshift CCC. Our work demonstrates how the generic modelling approach finds extensive use in the development of simulations of multi-tier facility networks that may contain multiple instances of generic simulation models of facilities at each network tier. Further, our work demonstrates how multi-tier healthcare facility network simulations can be leveraged for capacity planning in health crises.
新冠疫情给全球医疗设施带来了巨大压力,在一些国家,临时搭建的新冠疫情治疗中心已投入使用,以应对患者数量过多的情况。在印度等发展中国家,公共医疗系统(PHS)是一个层级式网络,患者从基层初级卫生保健中心(PHC)流向中级社区卫生中心(CHC),再向下游流向区级医院(DH)。在本研究中,我们展示了一种基于网络的建模与模拟方法,利用通用建模原则可以(a)量化公共医疗系统现有设施能够有效应对预测的新冠病例数量的程度;(b)为临时新冠疫情护理中心(CCC)的容量决策提供信息,以应对患者数量过多的情况。我们将该方法应用于对一个包含十个初级卫生保健中心、三个社区卫生中心、一个区级医院和一个临时护理中心的当地公共医疗系统的实证研究。我们的工作展示了通用建模方法如何在多层设施网络模拟的开发中得到广泛应用,这些网络可能在每个网络层级包含多个设施通用模拟模型的实例。此外,我们的工作展示了如何利用多层医疗设施网络模拟进行健康危机中的容量规划。