Med Decis Making - Principles of scarce medical resource allocation in natural disaster relief: a simulation approach.

Tópicos

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Resumo

CKGROUND: A variety of triage principles have been proposed. The authors sought to evaluate their effects on how many lives can be saved in a hypothetical disaster.OBJECTIVE: To determine an optimal scarce resource-rationing principle in the emergency response domain, considering the trade-off between lifesaving efficiency and ethical issues.METHOD: A discrete event simulation model is developed to examine the efficiency of four resource-rationing principles: first come-first served, random, most serious first, and least serious first. Seven combinations of available resources are examined in the simulations to evaluate the performance of the principles under different levels of resource scarcity.RESULT: The simulation results indicate that the performance of the medical resource allocation principles is related to the level of the resource scarcity. When the level of the scarcity is high, the performances of the four principles differ significantly. The least serious first principle performs best, followed by the random principle; the most serious first principle acts worst. However, when the scarcity is relieved, there are no significant differences among the random, first come-first served, and least serious first principles, yet the most serious first principle still performs worst.CONCLUSION: Although the least serious first principle exhibits the highest efficiency, it is not ethically flawless. Considering the trade off between the lifesaving efficiency and the ethical issues, random selection is a relatively fair and efficient principle for allocating scarce medical resources in natural disaster responses.

Resumo Limpo

ckground varieti triag principl propos author sought evalu effect mani live can save hypothet disasterobject determin optim scarc resourcer principl emerg respons domain consid tradeoff lifesav effici ethic issuesmethod discret event simul model develop examin effici four resourcer principl first comefirst serv random serious first least serious first seven combin avail resourc examin simul evalu perform principl differ level resourc scarcityresult simul result indic perform medic resourc alloc principl relat level resourc scarciti level scarciti high perform four principl differ signific least serious first principl perform best follow random principl serious first principl act worst howev scarciti reliev signific differ among random first comefirst serv least serious first principl yet serious first principl still perform worstconclus although least serious first principl exhibit highest effici ethic flawless consid trade lifesav effici ethic issu random select relat fair effici principl alloc scarc medic resourc natur disast respons

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