Deprem sonrası sağlık kaynaklarının optimizasyon yaklaşımıyla planlanması: Kırıkkale kent örneği
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Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Kırıkkale Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Afetler can ve mal kaybına neden olan, toplumlar üzerinde olumsuz etkiler oluşturan olaylardır. Depremler ise en sık görülen ve etkileri oldukça büyük olan afet türüdür. Deprem sonrası ortaya çıkan kaotik koşullar (zarar görmüş insan sayısı, zaman baskısı, iletişim problemi vb.) müdahale ve kurtarma sürecini zor hale getirir. Bu zor sürecin etkin yönetilebilmesi için eldeki kaynakların (malzeme, sağlık, barınma, ulaşım, AFAD ekipleri) başarılı bir şekilde enkaz bölgelerine tahsis edilmesi gerekmektedir. Depremlerden sonraki ilk saatlerde yaralıların, yaralanma şiddetlerine göre (ağır ve geciktirilebilir yaralı) ve geçen süre ile doğru orantılı olarak hayatta kalma olasılıkları daha fazladır; zaman ilerledikçe bu ihtimal giderek azalır. Dolayısıyla enkaz altından çıkarılan yaralılara ilk müdahalelerinin yapılması ve ihtiyaç görülenlerin acilen hastaneye sevk edilmesi gerekmektedir. Bu nedenle sağlık kaynakları planlaması depremin yıkıcı etkilerini azaltma açısından son derece önemlidir. Bu tez çalışmasında deprem sonrası hayatını kaybeden yaralı sayısının en aza indirilmesini amaçlayan 0-1 karışık tam sayılı bir matematiksel model geliştirilmiştir. Model içerisinde enkaz bölgelerine olay yeri triyajını gerçekleştirecek sağlık birimlerinin (doktor, hemşire, ekipman) tahsis edilmesi, olay yeri triyajı görmüş yaralıların hastaneye sevk işlemi için ambulans ataması yapılması ve ambulansların hangi hastanelere yönlendirilmesi gerektiği kararları verilmek istenmektedir. Geliştirilen modelin çok periyodlu olarak modellenmesi ve yaralıların sağlık durumlarındaki değişimin markov zinciri olarak ele alınması literatüre katkı olarak öne çıkmaktadır. Geliştirilen model, Kırıkkale ili için olası bir deprem senaryosundan elde edilen veriler ile GAMS CPLEX çözücüsü kullanılarak test edilmiştir. Elde edilen sonuçlar geliştirilen modelin sağlık kaynakları tahsisi için etkin bir planlama aracı olarak kullanılabileceğini göstermektedir.
Disasters that have negative effects on societies are extraordinary events causing loss of life and property. Earthquakes, on the other hand, are type of disasters that the most common and the effects of which are quite large. Chaotic conditions (the number of affected people, time pressure, communication problem, etc.) after an earthquake make it difficult the response and recovery process. In order to manage this difficult process effectively, available resources (supplies, health, housing, transportation, AFAD teams) needs to be successfully allocated to the affected areas. In the first hours after earthquakes, survival probabilities of the injured are more in direct proportion to the severity of the injury (severe and delayed injured) and the passing time. This possibility gradually decreases as time progresses. There for, first interventions needs to be done to the injured who taken out from under the wreckage and those who are immediately deemed necessary should be referred to the hospital. For this reason, health resource planning is extremely significant in terms of reducing the destructive effects of the earthquake. In this thesis work a 0-1 mixed integer mathematical model has been developed aimed at minimizing the number of died after the earthquake. Within the framework of the model, it is desired to allocate medical units (doctors, nurses, equipment) that will perform scene of accident triage to the affected areas and assign ambulances for the transfer of injured people who have seen the crime scene triage to the hospital, and make decisions about which hospitals ambulances should be directed to. The fact that the developed model is modeled on a multi-period basis and treats the change in the health status of the injured as the markov chain stands out as its contribution to the literature. The developed model was tested using GAMS CPLEX solvent with the data obtained from a possible earthquake scenario for Kırıkkale province. Obtained the results shows that the developed model can be used as an effective planning tool for health resource allocation.
Disasters that have negative effects on societies are extraordinary events causing loss of life and property. Earthquakes, on the other hand, are type of disasters that the most common and the effects of which are quite large. Chaotic conditions (the number of affected people, time pressure, communication problem, etc.) after an earthquake make it difficult the response and recovery process. In order to manage this difficult process effectively, available resources (supplies, health, housing, transportation, AFAD teams) needs to be successfully allocated to the affected areas. In the first hours after earthquakes, survival probabilities of the injured are more in direct proportion to the severity of the injury (severe and delayed injured) and the passing time. This possibility gradually decreases as time progresses. There for, first interventions needs to be done to the injured who taken out from under the wreckage and those who are immediately deemed necessary should be referred to the hospital. For this reason, health resource planning is extremely significant in terms of reducing the destructive effects of the earthquake. In this thesis work a 0-1 mixed integer mathematical model has been developed aimed at minimizing the number of died after the earthquake. Within the framework of the model, it is desired to allocate medical units (doctors, nurses, equipment) that will perform scene of accident triage to the affected areas and assign ambulances for the transfer of injured people who have seen the crime scene triage to the hospital, and make decisions about which hospitals ambulances should be directed to. The fact that the developed model is modeled on a multi-period basis and treats the change in the health status of the injured as the markov chain stands out as its contribution to the literature. The developed model was tested using GAMS CPLEX solvent with the data obtained from a possible earthquake scenario for Kırıkkale province. Obtained the results shows that the developed model can be used as an effective planning tool for health resource allocation.
Açıklama
Fen Bilimleri Enstitüsü, Endüstri Mühendisliği Ana Bilim Dalı
Anahtar Kelimeler
Endüstri ve Endüstri Mühendisliği, Industrial and Industrial Engineering
