Hybrid Modeling-Based Approach For Assessing And Enhancing Seismic Resilience Of Healthcare Systems

Healthcare systems play an important role in the response and recovery of earthquake-hit regions.However,healthcare systems themselves likely subject to earthquake impacts,which hinders medical service continuity.The enhancement of resilience to earthquakes is crucial for healthcare systems to maintain their functionality during earthquakes and recover in a timely manner in the aftermath of earthquakes.Nevertheless,the lack of an effective approach to assess the seismic resilience of a healthcare system makes it challenging for devising and benchmarking appropriate resilience enhancement measures.To address this gap,this dissertation proposes a hybrid modeling-based approach for assessing and enhancing the seismic resilience of healthcare systems.Firstly,the study constructs an agent-based model of the post-earthquake prehospital functionality of a single hospital.An indicator of the hospital post-earthquake pre-hospital functionality is first proposed.Then,the interactions between stakeholders during the pre-hospital medical response process are identified to establish the agentbased model of the pre-hospital functionality.The validity of the model is tested by both process validation and result validation.The validation results demonstrate that the simulated behavior is consistent with the realistic characteristics of the pre-hospital medical response after an earthquake.The model can serve as an effective tool to simulate the evolution of the pre-hospital functionality of a hospital after earthquakes.Secondly,the study constructs a system dynamics model of the post-earthquake inhospital functionality of a single hospital.Similarly,an indicator to reflect the postearthquake in-hospital functionality is proposed.The factors affecting the in-hospital functionality as well as their interrelationships are identified and constructed into a system dynamic model to simulate the in-hospital functionality.Through process validation and result validation,the model verifies the simulated behavior consistent with the realistic characteristics of the in-hospital treatment after earthquakes,which can serve as an effective tool to simulate the evolution of the in-hospital functionality of a hospital after earthquakes.Thirdly,the study proposes a hybrid modeling-based approach for assessing and enhancing the seismic resilience of a healthcare system.The indicators of the pre-hospital and in-hospital functionality of a healthcare system after earthquakes are constructed.Then,a hybrid model of the healthcare system post-earthquake functionality is built by integrating the agent-based models and the system dynamics models.Based on the hybrid model,an assessment approach of seismic resilience of a healthcare system is proposed,following which a resilience enhancement approach is put forward based on the multiple attribute decision making method.Finally,a case study is conducted in Mianzhu City of Sichuan Province,China,which was one of the worst-hit cities in the 2008 Sichuan Earthquake.The hybrid model is built to evaluate the seismic resilience of the case healthcare system.Based on the findings,healthcare seismic resilience enhancement schemes are proposed.The adaptive capacity to earthquakes of the case healthcare system is also studied based on analyzing its resilience level to the 2008 Sichuan Earthquake.The results of the case study validate the feasibility and effectiveness of the resilience assessment and enhancement approach proposed in this dissertation.The proposed approach contributes to analyzing the evolution of a healthcare system functionality after an earthquake and assessing the seismic resilience of a healthcare system.Moreover,the approach can serve as a decision-making tool to identify the weakness in the healthcare system seismic resilience and compare the effectiveness of different resilience enhancement measures so as to propose scientific and effective solutions.