Deprem sonrası sağlık kaynakları planlamasına yönelik matematiksel model önerisi: Kırıkkale kent örneği

Depremler can ve mal kaybına neden olan, en sık görülen, etkileri oldukça büyük afet türüdür. Deprem sonrası kaotik koşullar müdahale ve kurtarma sürecini zorlaştırır. Bu sürecin yönetilebilmesinde, eldeki kaynakların (sağlık, barınma, AFAD ekipleri vb.) başarılı bir şekilde enkaz bölgelerine tahsisi gerekmektedir. Depremlerden sonraki ilk saatlerde yaralıların, yaralanma şiddetlerine göre (ağır ve geciktirilebilir yaralı) ve geçen süreyle doğru orantılı olarak hayatta kalma olasılıkları daha fazladır; zaman ilerledikçe bu ihtimal azalır. Dolayısıyla enkazdan çıkarılan yaralılara ilk müdahalelerinin yapılması, ihtiyaç görülenlerin acilen hastaneye sevk edilmesi gerekmektedir. Bu nedenle sağlık kaynakları planlaması depremin yıkıcı etkilerinin azaltılmasında son derece önemlidir. Bu çalışmada deprem sonrası hayatını kaybeden yaralı sayısının en aza indirilmesini amaçlayan 0-1 karışık tam sayılı bir matematiksel model geliştirilmiştir. Model içerisinde enkaz bölgelerine olay yeri triyajını gerçekleştirecek sağlık birimlerinin (doktor, hemşire, ekipman) tahsis edilmesi, olay yeri triyajı görmüş yaralıların hastaneye sevk işlemi için ambulans ataması yapılması ve ambulansların hangi hastanelere yönlendirilmesi gerektiği kararları verilmek istenmektedir. Geliştirilen modelin çok periyodlu ve yaralıların sağlık durumlarındaki değişimin markov zinciri olarak modellemesi literatüre katkı olarak öne çıkmaktadır. Geliştirilen model, Kırıkkale ili için olası bir deprem senaryosu verileriyle GAMS CPLEX çözücüsü kullanılarak test edilmiştir. Test sonuçları, geliştirilen modelin sağlık kaynakları tahsisi için etkin bir planlama aracı olarak kullanılabileceğini göstermektedir.

Anahtar Kelimeler:

Deprem, kaynak tahsisi, optimizasyon, matematiksel programlama, karışık tam sayılı programlama

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