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Older Adults’ Health Care Utilization a Year After Experiencing Fear or Distress from Hurricane Sandy

Published online by Cambridge University Press:  05 February 2018

Laura P. Sands*
Affiliation:
Center for Gerontology, Virginia Tech, Blacksburg, Virginia
Yimeng Xie
Affiliation:
Department of Statistics, Virginia Tech, Blacksburg, Virginia
Rachel Pruchno
Affiliation:
New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, New Jersey
Allison Heid
Affiliation:
New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, New Jersey
Yili Hong
Affiliation:
Department of Statistics, Virginia Tech, Blacksburg, Virginia
*
Correspondence and reprints request to Laura P. Sands, PhD, Center for Gerontology, Virginia Tech, 230 Grove Lane, Blacksburg, VA 24061 (e-mail: [email protected]).

Abstract

Objective

To determine whether self-reports of disaster-related psychological distress predict older adults’ health care utilization during the year after Hurricane Sandy, which hit New Jersey on October 29, 2012.

Methods

Respondents were from the ORANJ BOWL Study, a random-digit dialed sample from New Jersey recruited from 2006 to 2008. Medicare hospital, emergency department (ED) and outpatient claims data from 2012 and 2013 were matched to 1607 people age 65 and older in 2012 who responded to follow-up surveys conducted from July 2013 to July 2015 to determine their hurricane-related experiences.

Results

In total, 7% (107) of respondents reported they experienced a lot versus 93% (1493) respondents reported they experienced little or no fear and distress from Hurricane Sandy. Those who experienced a lot versus little or no fear and distress had higher probability of all-cause hospital admissions and more ED visits through 3 months (hazard ratio [HR]: 2.19, 95% CI: 1.03-4.63; incidence ratio [IR]: 2.57, 95% CI: 1.21-5.35), and ED and outpatient visits (IR: 2.20, 95% CI: 1.44-3.37; IR: 1.37, 95% CI: 1.02-1.87) through the year after the hurricane.

Conclusions

A self-reported assessment of disaster-related psychological distress is a strong predictor of older adults’ health care needs the year after the disaster. The results indicate that disaster preparedness should extend beyond acute health care needs to address longer-term health consequences of disasters. (Disaster Med Public Health Preparedness. 2018;12:578–581)

Type
Brief Report
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2018 

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References

1. Heid, A, Christman, Z, Pruchno, R, et al. Vulnerable, but why? Post-traumatic stress symptoms in older adults exposed to Hurricane Sandy. Disaster Med Public Health Prep. 2016;10:362-370.Google Scholar
2. Acierno, R, Ruggiero, K, Galea, S, et al. Psychological sequelae resulting from the 2004 Florida Hurricanes: implications for postdisaster invtervention. Am J Public Health. 2007;97:S103-S108.Google Scholar
3. Pietrzak, R, Southwick, S, Tracy, M, Galea, S, Norris, F. Posttraumatic stress disorder, depression and perceived needs for psychological care in older persons affected by Hurricane Ike. J Affect Disord. 2012;138:96-103.Google Scholar
4. Andersen, R, Newman, J. Societal and individual determinants of medical care utilization in the United States. Millbank Q. 2005;83:1-28.Google Scholar
5. Crane, S, Tung, E, Hanson, G, et al. Use of an electronic administrative database to identify older community dwelling adults at high risk for hospitalization or emergency department visits: the elders risk assessment index. BMC Health Serv Res. 2010;10:338.Google Scholar
6. Walsh, P, Currier, G, Shah, M, Firedman, B. Older adults with mental disorders: what factors distinguish those who present to emergency departments for mental health reasons from those who do not? Am J Geriatr Psychiatry. 2015;23:1162-1171.Google Scholar
7. Kennedy, B, Kasl, S, Voccarino, V. Repeated hospitalizations and self-rated health among the elderly: A multivariate failure time model. Am J Epidemiol. 2001;153:232-241.Google Scholar
8. DePalma, G, Xu, H, Covinsky, K, et al. Hospital readmission among older adults who return home with unmet need for ADL disability. Gerontologist. 2013;53:454-461.Google Scholar
9. Polusny, M, Ries, B, Schultz, J, et al. PTSD symptom clusters associated with physical health and health care utilization in rural primary care patients exposed to a natural disaster. J Trauma Stress. 2008;21:75-82.Google Scholar
10. Radler, B, Ryff, C. Who participates? Accounting for longitudinal retention in the MIDUS National Study of Health and Well-Being. J Aging Health. 2010;22:307-331.Google Scholar