Post-earthquake medical service function evaluation and recovery optimization based on discrete event simulation

Hospitals are key systems for post-earthquake emergency treatment. However, they are prone to severe damage during earthquakes, affecting the medical service function. This study evaluates the dynamic evolution of hospital medical service function after an earthquake and proposes recovery strategies to enhance this function based on the discrete event simulation (DES) method. First, considering the damage to non-structural components, pipe systems, and medical equipment, a fault tree analysis (FTA) for critical hospital departments and wards is established, and a vulnerability analysis is conducted to assess the availability of departments and wards under different earthquake scenarios. Second, a DES model is constructed, encompassing four modules: patient triage module, treatment process module, resources allocation module and hospital repair module. The dynamic changes of the medical service function after the earthquake are simulated and assessed. Finally, considering two functional indicators of waiting time and treatment completion rate, a hospital department and ward repair sequence optimization model under resource constraints is constructed, and the NSGA-II algorithm is applied to solve for the optimal strategy. This method has been validated in a real hospital in China. The results show that damage to non-structural components, pipe systems, and medical equipment significantly impacts department and ward availability. Moreover, prioritizing the repair of critical departments and wards such as emergency departments and ICUs can significantly improve treatment efficiency and reduce waiting time, thereby enhancing the hospital's overall service function. This study provides theoretical support for post-earthquake hospital emergency response and recovery strategies, aiming to strengthen its service function. • Combining fault tree and vulnerability analysis to assess hospital availability. • Assessing the dynamic evolution of hospital medical service functions based on DES. • Constructing a multi-objective optimization model to optimize the recovery sequence. • Hospital medical service function decreases with increasing earthquake magnitude. • Increasing recovery resources can help to quickly recover medical service functions.