Multi attribute decision analysis in public health : analyzing the effectiveness of alternate modes of dispensing
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Local emergency planners are creating mass prophylaxis plans to prophylax entire populations within forty eight hours in order to reduce mortality after a bioterrorist attack. The Points of Dispensing (PODs) used in prophylaxis are central to an area?s mass prophylaxis plans, but they are insufficient because of their staffing and security constraints. Several alternate modes of dispensing that have similar attributes and are considered best practices are presently being implemented in local health departments (LHDs). The purpose of this thesis is to develop models to evaluate alternate modes of dispensing using multi-attribute value function (MAVF), an approach that supports multi-attribute decision-making by taking into account the trade-offs a decision-maker is willing to make between attributes. Two models are created for Los Angeles County (LAC). The models showed that in LAC, the door-to-door option, pharmacy option, civil service option and Kaiser Permanente option work best. The study finds that alternate modes of dispensing can be useful in filling the gaps in the POD-based approach by increasing critical resources or lowering the pressure on existing resources.
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