A network-based simulation framework for robustness assessment of accessibility in healthcare systems with the consideration of cascade failures

The accessibility of healthcare system is vulnerable to various types of hazards, where the failure of one system component may lead to a diffusion of the pressure and result in cascading failures. This study proposes a network-based simulation framework for robustness assessment of access to healthcare through integrating cascading failure mechanism. Weighted complex networks are constructed to model the accessible patient transfer under both general and elderly healthcare scenarios. The cascade failure mechanism is incorporated into the constructed networks, and several attack strategies (including random, initial degree (ID), initial betweenness (IB), recalculated degree (RD), and recalculated betweenness (RB) attack) are adopted to simulate the process of system robustness assessment. Results indicate that the proposed framework enables to discover the vulnerable nodes in the constructed healthcare accessibility networks, where the robustness metric combining network efficiency and relative size of the largest component acts as a benchmark; all the intentional attack strategies outperform the random attack strategy, which indicates the effectiveness of the detection of vulnerable healthcare facilities by the developed model; and the metrics of node degree and betweenness centrality make progress on identifying the vulnerable healthcare facility nodes, which should be taken heed of to optimize the management and operation of healthcare systems.