医疗系统抗震韧性评估指标体系
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摘要
该文提出一种量化医疗系统抗震韧性的评估框架,通过定义医疗系统功能、确定关键基础设施及支撑医疗系统功能的关键构件建立医疗系统模型。将医疗系统划分为5个医疗功能单元及7个子系统,每个子系统由不同的构件构成,由此建立医疗系统抗震韧性评估指标体系,并通过层次分析法确定指标体系各组成部分的权重系数用于后续的韧性评估。结果表明门诊急诊是5个医疗功能单元中最重要的(37.5%)。同时通过专家打分法确定了对应于地震救灾功能以及全部功能恢复所需要的时间需求(分别是8.13 d、27.27 d)。
The paper proposes a framework to quantitatively assess seismic resilience of a hospital system. The system model for a hospital system is first built by defining the functionality and by identifying supportive infrastructural subsystems and components. A hospital system is divided into five functional units and seven subsystems. Several different components constitute a subsystem and help support the functionality of the subsystem. Indicators system is established based on that. The weight coefficients of different functional units,subsystems and components are determined using an analytic hierarchy process(AHP). Weight coefficients are the base for the proposed quantitative framework. It is found that the emergency department has the highest weighting(37.5%) of the five functional units. Meanwhile, the recovery time demand of emergency function and complete function of a hospital system was also evaluated during the Delphi process(8.13 d and 27.27 d,respectively).
The paper proposes a framework to quantitatively assess seismic resilience of a hospital system. The system model for a hospital system is first built by defining the functionality and by identifying supportive infrastructural subsystems and components. A hospital system is divided into five functional units and seven subsystems. Several different components constitute a subsystem and help support the functionality of the subsystem. Indicators system is established based on that. The weight coefficients of different functional units,subsystems and components are determined using an analytic hierarchy process(AHP). Weight coefficients are the base for the proposed quantitative framework. It is found that the emergency department has the highest weighting(37.5%) of the five functional units. Meanwhile, the recovery time demand of emergency function and complete function of a hospital system was also evaluated during the Delphi process(8.13 d and 27.27 d,respectively).
引文
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[10]Cimellaro G P,Reinhorn A M,Bruneau M.Seismic resilience of a hospital system[J].Structure and Infrastructure Engineering,2010,6(1/2):127―144.
[2]Chang S E,Shinozuka M.Measuring improvements in the disaster resilience of communities[J].Earthquake Spectra,2004,20(3):739―755.
[3]Miles S B,Chang S E.Modeling community recovery from earthquakes[J].Earthquake Spectra,2006,22(2):439―458.
[4]Zhong S,Clark M,Hou X Y,et al.Development of key indicators of hospital resilience:A modified Delphi study[J].Journal of Health Services Research&Policy,2015,20(2):74.
[5]Cimellaro G P,Renschler C,Reinhorn A M,et al.Peoples:A framework for evaluating resilience[J].Journal of Structural Engineering,2016,142(10):04016063-1―04016063-13.
[6]Myrtle R C,Masri S F,Nigbor R L,et al.Classification and prioritization of essential systems in hospitals under extreme events[J].Earthquake Spectra,2005,21(3):779―802.
[7]GB 51039―2014,综合医院建筑设计规范[S].北京:中国计划出版社,2014.GB 51039―2014,Code for design of general hospital[S].Beijing:China Planning Press,2014.(in Chinese)
[8]Saaty T L.Basic theory of the analytic hierarchy process:How to make a decision[J].Revista De La Real Academia De Ciencias Exactas Físicas Y Naturales,1999,93(4):395―423.
[9]Saaty T L.How to make a decision:The analytic hierarchy process[J].European Journal of Operational Research,1990,48(1):9―26.
[10]Cimellaro G P,Reinhorn A M,Bruneau M.Seismic resilience of a hospital system[J].Structure and Infrastructure Engineering,2010,6(1/2):127―144.