Management Science · 2025 · Pieter L. van den Berg、Shane G. Henderson、Caroline J. Jagtenberg、Hemeng Li
中文摘要
在社区第一响应者 (CFR) 系统中,传统应急救援服务通过一个由经过培训的志愿者组成的网络得到增强,这些志愿者通过应用程序被派遣。此类系统的一个核心应用场景是院外心脏骤停 (OHCA),在这种情形下极快的响应速度至关重要。对于给定的目标绩效水平,需要多少志愿者,以及应从哪些地点招募他们?我们将志愿者在整个区域内的分布建模为泊松点过程,由此可以计算最先到达志愿者的响应时间分布。将其与已知的生存率函数相结合,我们推导出心脏骤停情境下的生存概率。随后,我们利用凸优化计算出志愿者在整个区域内的位置分布,以优化快速响应事件所占比例 (行业内常用的一项衡量指标) 或 OHCA 情境下患者的生存率。最优位置分布给出了在给定志愿者数量下所能达到的最佳绩效的界限。这可用于判断在新区引入 CFR 系统是否值得,也可作为在现有系统中进一步招募志愿者的指导。有效的招募目标区域并不总是显而易见的,因为从某一区域招募的志愿者可能因一天中时段的不同而分布在城市各处;我们明确刻画了这一问题。我们通过新西兰奥克兰的扩展案例研究展示了这些方法。
Abstract
In community first responder (CFR) systems, traditional emergency service response is augmented by a network of trained volunteers who are dispatched via an app. A central application of such systems is out-of-hospital cardiac arrest (OHCA), where a very fast response is crucial. For a target performance level, how many volunteers are needed, and from which locations should they be recruited? We model the presence of volunteers throughout a region as a Poisson point process, which permits the computation of the response-time distribution of the first-arriving volunteer. Combining this with known survival-rate functions, we deduce survival probabilities in the cardiac arrest setting. We then use convex optimization to compute a location distribution of volunteers across the region that optimizes either the fraction of incidents with a fast response (a common measure in the industry) or patient survival in the case of OHCA. The optimal location distribution provides a bound on the best possible performance with a given number of volunteers. This can be used to determine whether introducing a CFR system in a new region is worthwhile or can serve as a guide for additional recruitment in existing systems. Effective target areas for recruitment are not always obvious because volunteers recruited from one area may be found in various areas across the city depending on the time of day; we explicitly capture this issue. We demonstrate these methods through an extended case study of Auckland, New Zealand.