A network-based modelling framework for evaluation of the resilience of access to healthcare infrastructures

Abstract

The public healthcare system is an integral component of social welfare which plays a prominent role in ensuring the development of a national economy and social stability. The ability of a community to respond effectively to a crisis is largely dependent on the functionality of the healthcare infrastructures. The accessibility of timely, high-quality, relevant and indiscriminate healthcare services highlights the necessity of studying the resilience of access to healthcare infrastructures for city dwellers. However, some mishaps (e.g., extreme weather, sudden disaster, and malicious attacks) may result in the localized malfunctions of some healthcare facilities. Therefore, it is of immense importance to investigate the robustness and resilience of healthcare systems, which can guarantee the reliance and efficiency of healthcare service delivery to a large degree. Furthermore, a variety of resilient healthcare research has been focusing on everyday clinical works and a system’s abilities to adopt or absorb disturbing conditions. It is observed that resilient healthcare research needs to be lifted from its current state of descriptive and qualitative methods targeted at individuals towards an overarching theoretical interpretation of core resilience characteristics at multiple system levels through more rigorous research designs.

In response, the aim of the research is to develop a network-based modelling framework to improve the resilience of access to healthcare infrastructures. It consists of the development of an evaluation model for the accessibility to healthcare facilities; establishment of a simulation model, where the real system is abstracted and cascading failure mechanism is considered, to analyze the accessibility robustness in large healthcare service systems; and lastly provision of pragmatic and effective quantitative measures of resilience in the access to healthcare networks to help develop pre-disaster decision-making, upgrade the system’s serviceability and enhance the resilience of large healthcare systems.

The research has made several contributions to resilient healthcare research from theoretical, methodological and practical perspectives. Theoretically, this research proposes the network-based modelling framework that synergizes the complex network theory and cascading failure mechanism, ingests the state-of-art interconnected infrastructure system resilience measurements, and stimulates the quantification of the consolidated concept of accessibility, robustness and resilience. Methodologically, this research formulates network-based methods for assessing the resilience of healthcare facility accessibility networks. It would transform to be an effective tool in investigating the bottlenecks in the management and operation of the healthcare systems, and add to the knowledge regarding how healthcare systems adapt to stresses, pressures and complexities. Practically, this research implements the developed modelling framework to a real case study through which the hierarchical healthcare system in a community can be organized into a directed weighted complex network and used to facilitate infrastructure operators and managers to understand the infrastructure vulnerabilities towards the aim of enhancing the resilience of residents’ access to healthcare infrastructures.