Patient flow logistics from disaster to care: a scoping review of actors, transport modes and decision problems

Purpose – Sudden-onset disasters impact the health and well-being of millions of people each year. Typically, a sudden-onset disaster will lead to a surge of patients that require immediate acute care, even though health infrastructure and resources may be destroyed or not accessible. The challenge of patient flow logistics is transporting those in need of acute care rapidly to locations where they can be treated. The fields and disciplines tackling these challenges, therefore, span from disaster-related to health-related logistics, but it is not known whether and how research and approaches across these fields align. This study aims to scope this emergent field, identify research gaps and develop a conceptual framework that bridges the disaster-related and health-related logistics literature. Design/methodology/approach – This paper follows a scoping review protocol. The authors screened an initial 8, 491 papers, of which 127 were retained for a full-text review. Analyzing these papers, the authors map out the key concepts such as actors, locations, transportation modes and decision problems used in the literature. The study identifies research gaps and synthesize the findings into a conceptual framework to guide future research. Findings – This review identified four gaps in the existing literature: (1) The literature focuses primarily on earthquakes and terrorist attacks, limited attention is given to other sudden-onset disaster types despite their frequency; (2) The literature focuses on formal actors such as health providers or civil protection bodies, while communities are largely portrayed as passive patients or victims; (3) Actors are largely assumed to follow standardized protocols, often ignoring emergent roles or behavioral changes typical for sudden-onset disasters; (4) Objectives predominantly relate to either efficiency or effectiveness, neglecting fairness and multiobjective problems. Originality/value – To the best of the authors’ knowledge, this scoping review is the first to explore the different aspects of patient logistics in sudden-onset disasters by bridging the disaster-related and health-related literature.