Resource-Based Patient Prioritization in Mass-Casualty Incidents

• 成果类型: Article
• 署名作者: Mills, Alex F.; Argon, Nilay Tanik; Ziya, Serhan
• 署名单位: Indiana University System; IU Kelley School of Business; Indiana University Bloomington; University of North Carolina; University of North Carolina Chapel Hill
• 刊物名称: M&SOM-MANUFACTURING & SERVICE OPERATIONS MANAGEMENT
• ISSN/ISSBN: 1523-4614
• DOI: 10.1287/msom.1120.0426
• 发表日期: 2013
• 页码: 361-377
• 关键词: health operations; emergency response; TRIAGE

摘要

T he most widely used standard for mass-casualty triage, START, relies on a fixed-priority ordering among different classes of patients, and does not explicitly consider resource limitations or the changes in survival probabilities with respect to time. We construct a fluid model of patient triage in a mass-casualty incident that incorporates these factors and characterize its optimal policy. We use this characterization to obtain useful insights about the type of simple policies that have a good chance to perform well in practice, and we demonstrate how one could develop such a policy. Using a realistic simulation model and data from emergency medicine literature, we show that the policy we developed based on our fluid formulation outperforms START in all scenarios considered, sometimes substantially.