Dynamic coordination of ambulances for emergency medical assistance services

Comprehensive Risk Analysis of Emergency Medical Response Systems in Serbian Healthcare: Assessing Systemic Vulnerabilities in Disaster Preparedness and Response

BACKGROUND/OBJECTIVES

Emergency Medical Response Systems (EMRSs) play a vital role in delivering medical aid during natural and man-made disasters. This quantitative research delves into the analysis of risk and effectiveness within Serbia's Emergency Medical Services (EMS), with a special emphasis on how work organization, resource distribution, and preparedness for mass casualty events contribute to overall disaster preparedness.

METHODS

The study was conducted using a questionnaire consisting of 7 sections and a total of 88 variables, distributed to and collected from 172 healthcare institutions (Public Health Centers and Hospitals). Statistical methods, including Pearson's correlation, multivariate regression analysis, and chi-square tests, were rigorously applied to analyze and interpret the data.

RESULTS

The results from the multivariate regression analysis revealed that the organization of working hours (β = 0.035) and shift work (β = 0.042) were significant predictors of EMS organization, explaining 1.9% of the variance (R2 = 0.019). Furthermore, shift work (β = -0.045) and working hours (β = -0.037) accounted for 2.0% of the variance in the number of EMS points performed (R2 = 0.020). Also, the availability of ambulance vehicles (β = 0.075) and financial resources (β = 0.033) explained 4.1% of the variance in mass casualty preparedness (R2 = 0.041). When it comes to service area coverage, the regression results suggest that none of the predictors were statistically significant. Based on Pearson's correlation results, there is a statistically significant correlation between the EMS organization and several key variables such as the number of EMS doctors (p = 0.000), emergency medicine specialists (p = 0.000), etc. Moreover, the Chi-square test results reveal statistically significant correlations between EMS organization and how EMS activities are conducted (p = 0.001), the number of activity locations (p = 0.005), and the structure of working hours (p = 0.001).

CONCLUSIONS

Additionally, the results underscore the necessity for increased financial support, standardized protocols, and enhanced intersectoral collaboration to strengthen Serbia's EMRS and improve overall disaster response effectiveness. Based on these findings, a clear roadmap is provided for policymakers, healthcare administrators, and EMS personnel to prioritize strategic interventions and build a robust emergency medical response system.

Dynamic ambulance relocation: a scoping review

OBJECTIVES

Dynamic ambulance relocation means that the operators at a dispatch centre place an ambulance in a temporary location, with the goal of optimising coverage and response times in future medical emergencies. This study aimed to scope the current research on dynamic ambulance relocation.

DESIGN

A scoping review was conducted using a structured search in PubMed, Scopus and Web of Science. In total, 21 papers were included.

RESULTS

Most papers described research with experimental designs involving the use of mathematical models to calculate the optimal use and temporary relocations of ambulances. The models relied on several variables, including distances, locations of hospitals, demographic-geological data, estimation of new emergencies, emergency medical services (EMSs) working hours and other data. Some studies used historic ambulance dispatching data to develop models. Only one study reported a prospective, real-time evaluation of the models and the development of technical systems. No study reported on either positive or negative patient outcomes or real-life chain effects from the dynamic relocation of ambulances.

CONCLUSIONS

Current knowledge on dynamic relocation of ambulances is dominated by mathematical and technical support data that have calculated optimal locations of ambulance services based on response times and not patient outcomes. Conversely, knowledge of how patient outcomes and the working environment are affected by dynamic ambulance dispatching is lacking. This review has highlighted several gaps in the scientific coverage of the topic. The primary concern is the lack of studies reporting on patient outcomes, and the limited knowledge regarding several key factors, including the optimal use of ambulances in rural areas, turnaround times, domino effects and aspects of working environment for EMS personnel. Therefore, addressing these knowledge gaps is important in future studies.

A decomposition-based multiobjective evolutionary algorithm using Simulated Annealing for the ambulance dispatching and relocation problem during COVID-19

The outbreak of the COVID-19 epidemic has had a significant impact in increasing the number of emergency calls, which causes significant problems to emergency medical services centers (EMS) in many countries around the world, such as Saudi Arabia, which attracts a huge number of pilgrims during pilgrimage seasons. Among these issues, we address real-time ambulance dispatching and relocation problems (real-time ADRP). This paper proposes an improved MOEA/D algorithm using Simulated Annealing (G-MOEA/D-SA) to handle the real-time ADRP issue. The simulated annealing (SA) seeks to obtain optimal routes for ambulances to cover all emergency COVID-19 calls through the implementation of convergence indicator based dominance relation (CDR). To prevent the loss of good solutions once they are found in the G-MOEA/D-SA algorithm, we employ an external archive population to store the non-dominated solutions using the epsilon dominance relationship. Several experiments are conducted on real data collected from Saudi Arabia during the Covid-19 pandemic to compare our algorithm with three relevant state-of-art algorithms including MOEA/D, MOEA/D-M2M and NSGA-II. Statistical analysis of the comparative results obtained using ANOVA and Wilcoxon test demonstrate the merits and the outperformance of our G-MOEA/D-SA algorithm.

Ambulances Deployment Problems: Categorization, Evolution and Dynamic Problems Review

In this paper, an analytic review of the recent methodologies tackling the problem of dynamic allocation of ambulances was carried out. Considering that state-of-the-art is moving to deal with more extensive and dynamic problems to address in a better way real-life instances, this research looks to identify the evolution and recent applications of this kind of problem once the basic models are explored. This extensive review allowed us to identify the most recent developments in this problem and the most critical gaps to be addressed. In this sense, it is essential to point out that the dynamic location of emergency medical services (EMS) is nowadays a relevant topic considering its impact on the healthcare system outcomes. Issues related to forecasting, simulation, heterogeneous fleets, robustness, and solution speed for real-life problems, stand out in the identified gaps. Applications of machine learning the deployment challenges during epidemic outbreaks such as SARS and COVID-19 were also explored. At the same time, a proposed notation tries to tackle the fact that the word problem in this kind of work refers to a model on many occasions. The proposed notation eases the comparison between the different model proposals found in the literature.

Agriculture fleet vehicle routing: A decentralised and dynamic problem

To date, the research on agriculture vehicles in general and Agriculture Mobile Robots (AMRs) in particular has focused on a single vehicle (robot) and its agriculture-specific capabilities. Very little work has explored the coordination of fleets of such vehicles in the daily execution of farming tasks. This is especially the case when considering overall fleet performance, its efficiency and scalability in the context of highly automated agriculture vehicles that perform tasks throughout multiple fields potentially owned by different farmers and/or enterprises. The potential impact of automating AMR fleet coordination on commercial agriculture is immense. Major conglomerates with large and heterogeneous fleets of agriculture vehicles could operate on huge land areas without human operators to effect precision farming. In this paper, we propose the Agriculture Fleet Vehicle Routing Problem (AF-VRP) which, to the best of our knowledge, differs from any other version of the Vehicle Routing Problem studied so far. We focus on the dynamic and decentralised version of this problem applicable in environments involving multiple agriculture machinery and farm owners where concepts of fairness and equity must be considered. Such a problem combines three related problems: the dynamic assignment problem, the dynamic 3-index assignment problem and the capacitated arc routing problem. We review the state-of-the-art and categorise solution approaches as centralised, distributed and decentralised, based on the underlining decision-making context. Finally, we discuss open challenges in applying distributed and decentralised coordination approaches to this problem.

Parallel CNN based big data visualization for traffic monitoring

In a real-time application such as traffic monitoring, it is required to process the enormous amount of data. Traffic prediction is essential for intelligent transportation systems (ITSs), traffic management authorities, and travelers. Traffic prediction has become a challenging task due to various non-linear temporal dynamics at different locations, complicated underlying spatial dependencies, and more extended step forecasting. To accommodate these instances, efficient visualization and data mining techniques are required to predict and analyze the massive amount of traffic big data. This paper presents a deep learning-based parallel convolutional neural network (Parallel-CNN) methodology to predict the traffic conditions of a specific region. The methodology of deep learning contains multiple processing layers and performs various computational strategies, which is used to learn representations of data with multilevel abstraction. The data has captured from the department of transportation; thus, the size of data is vast, and it can be analyzed to get the behavior of the traffic condition. The purpose of this paper is to monitor traffic behavior, which enables the user to make decisions to build the traffic-free cities. Experimental results show that the proposed methodology outperforms other existing methods such as KNN, CNN, and FIMT-DD.