IMPACT OF INTERDEPENDENCIES BETWEEN INFRASTRUCTURE SYSTEMS IN THE OPERATION OF HEALTH CARE FACILITIES DURING DISASTER EVENTS

Infrastructures systems cover a large number of sectors, including the national power grid, oil and natural gas production, transportation, and distribution networks, telecommunications and information systems, water systems, transportation networks, the banking and finance industry, the chemical industry, agriculture and food systems, and public health networks. These systems do not exist in isolation of one another – telecommunications networks require electricity, transportation networks require systems information to operate, generation of electricity requires fuel, emergency systems require transportation networks, and so forth. Interdependencies give rise to numerous challenges that do not exist in single infrastructure models. During a disaster event, health care facilities are expected to operate efficiently in order to provide care to injured patients. Traditionally, it has been assumed by disaster planners that these facilities are capable of providing services under the most extreme circumstances. However, medical care for injured patients can be affected if health care facilities do not have sufficient supply of electric power, water supply, or effective access to road transportation networks, etc. This paper presents two mathematical models that may be used to assess the level of interdependencies between the health care facility and the primary infrastructure systems linked to the facility. These models use linear programming to determine the unsatisfied demand in the major infrastructure systems and the impact of this shortage of resources on the operation of the hospital. The models described in this paper show the impact of a disruption when interdependencies among infrastructures are considered and supports strategy development and decision making during the restoration process. The framework and modeling used in this paper can assist in determining cost-effective operational strategies in a health care facility in order to respond to a disaster event considering the 1

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