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Planning for Baseline Medical Care Needs of a Displaced Population After a Disaster

Published online by Cambridge University Press:  08 April 2013

Abstract

Objective: To build a tool to assist disaster response planning and estimate the numbers of displaced persons that will require special medical care during a disaster.

Methods: We developed a tool, titled MedCon:PreEvent, which incorporates data from the 2006 National Health Interview Survey, 2005 National Hospital Discharge Survey, and 2004 National Nursing Home Survey to calculate numbers of emergency room/emergency department (ER/ED) visits, surgeries, health care home visits, overnight hospital stays, office visits, and self-rated health status. We then used thresholds of more than 12 office visits or 6 or more ER/ED visits or 6 or more surgeries or more than 4 home visits or more than 6 overnight hospital stays within the past 12 months to calculate rates per million evacuees requiring special medical care, including daily bed hospital and nursing home bed occupancy.

Results: We calculated that 79 428 (95% CI = 76 940-81 770) per million evacuees would need special medical care. The daily occupation of hospital beds would be 1710 beds (95% CI = 1328-2160) per million. The occupation of nursing home beds would be 5094 beds (95% CI = 5040-5148) per million. Changing the threshold to just those who self-rated health as “poor,” the demand for special medical care would be 24 348 (95% CI = 23 087-25 535) per million. Using threshold utilization values at half the original level would increase the estimate to 226 988 (95% CI = 224 444-229 384) per million.

Conclusions: A substantial number of persons with preexisting conditions will need suitable medical care following a disaster. The MedCon:PreEvent tool can assist disaster planners to prepare for medical care needs of large numbers of evacuees and consider re-evaluating the approach to utilizing and augmenting medical care services.

(Disaster Med Public Health Preparedness. 2012;6:335–341)

Type
Original Research
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2012

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References

REFERENCES

1.Ford, ESMokdad, AHLink, MW, et alChronic disease in health emergencies: in the eye of the hurricane. Prev Chronic Dis. 2006;3(2):A46.Google Scholar
2.Sharma, AJWeiss, ECYoung, SL, et alChronic disease and related conditions at emergency treatment facilities in the New Orleans area after Hurricane Katrina. Disaster Med Public Health Prep. 2008;2(1):2732.CrossRefGoogle ScholarPubMed
3.Holt, JBMokdad, AHFord, ESSimoes, EJMensah, GABartoli, WP. Use of BRFSS data and GIS technology for rapid public health response during natural disasters. Prev Chronic Dis. 2008;5(3):A97. http://www.cdc.gov/pcd/issues/2008/jul/07_0159.htm. Accessed July 1, 2008.Google Scholar
4.Arrieta, MIForeman, RDCrook, EDIcenogle, ML. Providing continuity of care for chronic diseases in the aftermath of Katrina: from field experience to policy recommendations. Disaster Med Public Health Prep. 2009;3(3):174182.CrossRefGoogle ScholarPubMed
5.Kessler, RC; Hurricane Katrina Community Advisory Group. Hurricane Katrina's impact on the care of survivors with chronic medical conditions. J Gen Intern Med. 2007;22(9):12251230.Google Scholar
6.Select Bipartisan Committee. A Failure of Initiative: Final Report of the Select Bipartisan Committee to Investigate the Preparation for and Response to Hurricane Katrina. Washington, DC: 109th US Congress; 2006. http://www.c-span.org/pdf/katrinareport.pdf.Google Scholar
7.Greenough, PGKirsh, TD. Hurricane Katrina: public health response—assessing needs. N Engl J Med. 2005;353(15):15441546.Google Scholar
8.Brodie, MWeltzien, EAltman, DBlendon, RJBenson, JM. Experiences of Hurricane Katrina evacuees in Houston shelters: implications for future planning. Am J Public Health. 2006;96(8):14021408.CrossRefGoogle ScholarPubMed
9.Cefalu, WTSmith, SRBlonde, LFonseca, V. The Hurricane Katrina aftermath and its impact on diabetes care: observations from “ground zero”: lessons in disaster preparedness of people with diabetes. Diabetes Care. 2006;29(1):158160.CrossRefGoogle ScholarPubMed
10.Greenough, PGLappi, MDHsu, EB, et alBurden of disease and health status among Hurricane Katrina-displaced persons in shelters: a population-based cluster sample. Ann Emerg Med. 2008;51(4):426432.CrossRefGoogle ScholarPubMed
11.Klein, KRNagel, NE. Mass medical evacuation: Hurricane Katrina and nursing experiences at the New Orleans airport. Disaster Manag Response. 2007;5(2):5661.Google Scholar
12.Shrestha, SSMeltzer, MISosin, DM. MedCon:PreEvent. A spreadsheet-based software to estimate pre-event population at risk of medical consequences in a disaster. Atlanta, GA: Centers for Disease Control and Prevention. http://emergency.cdc.gov/planning/medcon/.Google Scholar
13.National Center for Health Statistics. National Health Interview Survey (NHIS) Public Use Data Release: NHIS Survey Description. 2006 Centers for Disease Control and Prevention; June 2007. ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NHIS/2006/srvydesc.pdf. Accessed March 6, 2008.Google Scholar
14.Blossfeld, HRohwer, G. Techniques of Event History Modeling: New Approaches to Casual Analysis. Hillsdale, NJ: Lawerence Erlbaum Associates; 2002.Google Scholar
15.DeSalvo, KBBloser, NReynolds, KHe, JMunter, P. Mortality prediction with a single general self-rated health question: a meta-analysis. J Gen Intern Med. 2005;20:267275.Google Scholar
16.Pan, LMukhtar, QGeiss, SLRivera, MAlfaro_Correa, ASniegowski, R. Self-rated fair or poor health among adults with diabetes—United States, 1996-2005. JAMA. 2006;296(24):29192920.Google Scholar
17.Kennedy, BSKasl, SVVaccarino, V. Repeated hospitalizations and self-rated health among the elderly: a multivariate failure time analysis. Am J Epidemiol. 2001;153(3):232241.Google Scholar
18.Gavagan, TFSmart, KPalacio, H, et alHurricane Katrina: medical response at the Houston Astrodome/Reliant Center Complex. South Med J. 2006;99(9):933939.Google Scholar
19.Agency for Healthcare Research and Quality. Surge Capacity: Facilities and Equipment. Issue Brief No. 8. Rockville, MD: Agency for Healthcare Research and Quality; October 2005. http://archive.ahrq.gov/news/ulp/btbriefs/btbrief8.htm. Accessed October 12, 2012.Google Scholar
20.Kaji, AHKoenig, KLLewis, RJ. Current hospital disaster preparedness. JAMA. 2007;298(18):21882190.Google Scholar
21.American Hospital Association. Reports and studies page. Chicago, IL: American Hospital Association. http://www.aha.org/aha/resource-center/Statistics-and-Studies/studies.html. Accessed on February 15, 2009.Google Scholar
22. American Hospital Association Trendwatch Chartbook 2008: trends affecting hospitals and health systems. http://www.aha.org/aha/research-and-trends/chartbook/2008print/2008chartbk-printapp3.pdf. Accessed February 17, 2009.Google Scholar