Optimal Adaptation Process of Emergency Medical Services Systems in a Changing Environment

Quality of emergency medical services (EMS) depends on the EMS infrastructure which is subject to exogenous conditions, like the considered demand area. Demographic changes, increased traffic volume, and structural modifications in the urban infrastructure lead to permanent changes in the demand area. To provide high EMS quality in a strategic perspective, an adaptive planning system to consider these future environmental changes is necessary. An anticipatory adaptation process based on the existing EMS infrastructure and anticipating future developments has to be determined. Assessment criteria of an adaptation process include (1) EMS quality, (2) periodic operating costs, and (3) system adaptation costs. A linear multi-criteria program is developed to support EMS decision makers to dynamically improve an existing EMS infrastructure with respect to multiple requirements during a strategic time horizon.