Hospital Medical Surge Capacity Assessment and Planning Tools for Disaster Response: A Systematic Review and Meta-analysis
Clinical Snapshot
PICO Framework
| P — Population | Hospitals and healthcare systems requiring disaster surge capacity planning |
| I — Intervention | Surge capacity assessment and planning tools (simulation tools, surveys, resource strategies) |
| C — Comparator | Standard or alternative surge capacity planning approaches |
| O — Outcomes | Reliability, validity, and applicability of surge capacity tools; preparedness improvement measures |
Bottom Line
This systematic review suggests simulation-based surge capacity tools show promise for hospital disaster preparedness, with moderate overall effectiveness (ES = 0.74). However, substantial heterogeneity between studies (I² = 76.70%) and confirmed publication bias significantly limit confidence in these findings. Simulation tools demonstrated the most consistent results, while resource-based strategies showed high variability, suggesting context-dependent effectiveness. The review's methodological limitations, including restricted database searching and lack of GRADE assessment, weaken the evidence base. For Australian healthcare systems, these findings support continued investment in simulation-based preparedness training, but implementation should be tailored to local disaster risks and healthcare infrastructure. More rigorous primary studies with standardised outcome measures are needed before definitive practice recommendations can be made.
Key Findings
P Value: Not explicitly reported for primary outcome
Effect Size: Combined effect size 0.74 (moderate improvement)
Primary Outcome: Surge capacity tool effectiveness measured by preparedness improvement
Nnt Or Sensitivity: Simulation tools most effective (ES = 0.81, I² = 0%); resource strategies most variable (ES = 0.71, I² = 74.42%)
Confidence Interval: 95% CI: 0.67-0.82
Clinical Application
Implementation depends on institutional resources, training requirements, and integration with existing emergency protocols Relevant to Australian disaster preparedness given bushfire, flood, and pandemic experiences; aligns with National Health Emergency Response Arrangements and state-based health emergency management frameworks Hospital emergency management teams, disaster preparedness coordinators, and healthcare system planners
Abstract
BACKGROUND: Hospital surge capacity is pivotal for disaster response, yet the effectiveness of assessment and planning tools remains underexplored. OBJECTIVE: This systematic review evaluates the reliability, validity, and applicability of surge capacity tools across disaster scenarios. METHODS: Following PRISMA guidelines, we analyzed 24 Q1 studies (PubMed, Scopus) using the PICO framework. Risk of bias was assessed via ROBINS-E, and meta-analysis (random-effects model) quantified pooled effect sizes (ES). Subgroup analyses compared simulation tools, surveys, and resource strategies. RESULTS: The combined ES was 0.74 (95% CI: 0.67-0.82), indicating moderate improvement in preparedness. Simulation tools (Group A) showed the highest consistency (ES = 0.81, I2 = 0%), while resource strategies (Group C) had wider variability (ES = 0.71, I2 = 74.42%). Egger's regression revealed publication bias (P = 0.004), and heterogeneity was substantial (I2 = 76.70%). CONCLUSIONS: Simulation-based tools are most effective for surge capacity, whereas resource strategies require contextual adaptation. Policymakers should prioritize standardized benchmarks and DSS integration, with future research addressing equity and real-world implementation gaps.
References
- 1.Dinar, H. H. A., Othman, O. A. F., & Hubloue, I. (2026). Hospital Medical Surge Capacity Assessment and Planning Tools for Disaster Response: A Systematic Review and Meta-analysis. Disaster Medicine and Public Health Preparedness. https://doi.org/10.1017/dmp.2026.10370
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