Post-earthquake medical evacuation system design based on hierarchical multi-objective optimization model: An earthquake case study

Abstract Post-earthquake medical evacuation (MEDEVAC) is a significant public health issue, and the transfer of injured people for medical care is time-sensitive. A well-designed MEDEVAC program, which deploys the emergency medical facilities and plans the evacuation routes, can reduce transport time and improve survival rates. In this paper, we develop models to guide the deployment of the MEDEVAC system with three echelons, i.e., the injured, first-line medical centers, and second-line hospitals. We generalize existing location models and formulate multi-objective coverage models by minimizing the relief budget and the total weighted distance. We use the multi-criteria decision approach to estimate the medical demand that is used for optimization and model evaluation. Multi-hazard risks and existing medical resources are incorporated to select a preferred solution. Using data from Wenchuan, China, results suggest that improvements in survival and cost-effectiveness are possible with optimization and sensitivity analysis highlights the robustness of our approach in seismic intensity and distribution of the injured.