Resource‐Based Patient Prioritization in Mass‐Casualty Incidents

Resource‐Based Patient Prioritization in Mass‐Casualty Incidents

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Article ID: iaor20133826
Volume: 15
Issue: 3
Start Page Number: 361
End Page Number: 377
Publication Date: Jun 2013
Journal: Manufacturing & Service Operations Management
Authors: , ,
Keywords: allocation: resources
Abstract:

The 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.

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