Physician Manpower Mobilization after a Major Disaster in Taiwan

Abstract

Objectives. In the initial hours following a major disaster, emergency departments must cope with mass casualties. The efficiency of physician manpower mobilization affects the supply of medical care. The purpose of this study was to analyze the pattern of manpower mobilization and to assess the capacity of medical care at EDs in the field to improve the efficiency of the medical response after a disaster. Methods. In this study, we assessed physician manpower following the Chi-Chi earthquake in Taiwan on 21 September 1999. Data on the number of patients were collected from hospitals in three major disaster sites. The hospital treatment capacity was analyzed by de Boer's rule and the American College of Emergency Physicians (ACEP) physician treatment capacity rule. Results. The average rate of physician mobilization was 12% per-hour in the initial 2 hours, while the rate from the 2nd to 6th hour was 6% per-hour. The capacities of hospitals with the most mass casualties varied considerably. The hospitals with the most mass casualties lacked sufficient physician manpower in the initial post-quake hours. Conclusions. The requirement and utilization of physician manpower in the crucial period after a large scale disaster remains a great challenge for the medical disaster response system. In designing disaster response protocols, physician manpower should be expanded to include non-hospital physicians in the initial hours after major disasters.