Structural vulnerability and functional capacity limitations of hospitals in Puerto Rico in response to a major earthquake

Background: According to the Puerto Rico College of Engineers and Land Surveyors (CIAPR for the Spanish acronym), the vulnerability of the Island's hospitals depends on their construction year. The CIAPR indicate that hospitals built before the adoption of the Buildings Regulation of 1987 have a high risk of suffering significant damages from a major earthquake impacting the Island. Objective: Assess structural vulnerability and functional capacity limitations of hospitals in Puerto Rico in response to a major earthquake. Methods: A survey was conducted to characterize hospital ED level of preparedness and response to a MFI. Thirty-nine hospitals of a sample of 44 participated in the study. The administered questionnaires explored the following: general hospital characteristics; emergency plans; equipment and infrastructure; collaborative agreements; personnel trainings; emergency communications; laboratory facilities; treatment protocols; security; and epidemiologic surveillance. Results: Findings show that the vast majority of hospitals included in the study (92.1%) were built before 1987. In addition, 97.4% of the hospitals indicated their compliance with the American Institute of Architects' Guidelines for Design and Construction of Hospitals and Health Care Facilities. Moreover, almost a fifth of the hospitals (18.4%) identified functional capacity limitations in terms of beds, isolation rooms, and decontamination facilities to respond to a mass casualty event Conclusion: According to the construction year, the majority of hospitals included in this study have a high risk of suffering significant damage as a result of a major earthquake. All hospitals built before 1987 must implement a structural evaluation program and conduct anti-seismic improvements.