Abstract
Home health care (HHC) services are of vital importance for the health care system of many countries. Further increases in their demand must be expected and with it grows the need to sustain these services in times of disasters. Existing risk assessment tools and guides support HHC service providers to secure their services. However, they do not provide insights on interdependencies of complex systems like HHC. Causal-Loop-Diagrams (CLDs) are generated to visualize the impacts of epidemics, blackouts, heatwaves, and floods on the HHC system. CLDs help to understand the system design as well as cascading effects. Additionally, they simplify the process of identifying points of action in order to mitigate the impacts of disasters. In a case study, the course of the COVID-19 pandemic and its effects on HHC in Austria in spring 2020 are shown. A decision support system (DSS) to support the daily scheduling of HHC nurses is presented and applied to numerically analyze the impacts of the COVID-19 pandemic, using real-world data from a HHC service provider in Vienna. The DSS is based on a Tabu Search metaheuristic that specifically aims to deal with the peculiarities of urban regions. Various transport modes are considered, including time-dependent public transport.
Highlights
Many countries are experiencing a significant increase in demand for long-term care
The results are returned as a report (Html format) and as raw data (Json format) in order to display and further process the schedules in the existing software systems of the health care (HHC) service provider
HHC services are rising in importance in the health care systems of many countries and with it grows the need to sustain these services in times of disasters
Summary
Many countries are experiencing a significant increase in demand for long-term care. The average share of the population aged 65+ years in OECD countries increased from about 9% in 1960 to 17% in 2015, and is forecast to reach 28% in 2050. HHC services already have direct access to one of the most vulnerable groups, which provides in-depth knowledge of their medical needs, impairments, resources, as well as their home environments It enables targeted dissemination of public health (e.g., about vaccinations) and disaster preparedness information. The focus of this paper lies on the vulnerability assessments as we think that the existing HHC literature and risk assessment tools are deficient in this area While they provide great guidelines for the remaining steps, they offer little help in terms of insights into interdependencies. The ARC is one of the largest HHC service providers in Austria, and has extensive expertise in health care and disaster management The effects of these disasters have been analyzed on the basis of scientific publications, addressing general disaster impacts on critical infrastructure and lessons learned from specific events. The CLDs for each of these disasters are presented
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