Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-28T09:37:58.540Z Has data issue: false hasContentIssue false
  • English
  • Français

Effect of Hurricane Sandy on Health Care Services Utilization Under Medicaid

Published online by Cambridge University Press:  16 May 2016

Mark J. Sharp ,
Mingzeng Sun ,
Tatiana Ledneva ,
Ursula Lauper ,
Cristian Pantea  and
Shao Lin
Mark J. Sharp*
Affiliation:
New York State Department of Health, Albany, New York
Mingzeng Sun
Affiliation:
New York State Department of Health, Albany, New York
Tatiana Ledneva
Affiliation:
New York State Department of Health, Albany, New York
Ursula Lauper
Affiliation:
State University of New York at Albany, School of Public Health, Albany, New York.
Cristian Pantea
Affiliation:
New York State Department of Health, Albany, New York
Shao Lin
Affiliation:
State University of New York at Albany, School of Public Health, Albany, New York.
*
Correspondence and reprint requests to Mark J. Sharp, PhD, Office of Quality and Patient Safety, New York State Department of Health, ESP Corning Tower Rm 1911, Albany, NY 12237 (e-mail: [email protected]).
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

This investigation assessed changes in utilization of inpatient, outpatient, emergency department, and pharmacy services in the aftermath of Hurricane Sandy in 8 counties in New York affected by the storm.

Methods

Medicaid data for enrollees residing in 8 counties in New York were used to obtain aggregated daily counts of claims for 4 service types over immediate, 3-month, and 1-year periods following the storm. Negative binomial regression was used to compare service utilization in the storm year with the 2 prior years, within areas differentially affected by the storm.

Results

Changes in service utilization within areas inside or outside the storm zone were most pronounced over the 1-year effect period. Differences in service utilization by year were the same by storm zone designation over the immediate effect period for all services.

Conclusions

Results are consistent with previous investigations demonstrating that some of the greatest effects of a disaster on health services utilization occur well beyond the initial event. One-year effects, combined with some 3-month effects, suggests that storm recovery, with its effect on health care services utilization, may have followed different paths in areas designated as inside or outside the storm zone. (Disaster Med Public Health Preparedness. 2016;10:472–484)

Keywords

Hurricane SandyMedicaidhealth care services utilization
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 10 , Special Issue 3: Superstorm Sandy , June 2016 , pp. 472 - 484
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Blake, ES, Kimberlain, TB, Berg, RJ, et al. Tropical Cyclone Report: Hurricane Sandy. National Oceanic and Atmospheric Administration. http://www.nhc.noaa.gov/data/tcr/AL182012_Sandy.pdf. Published February 12, 2013. Accessed October 16, 2015.Google Scholar
2. Brackbill, RM, Caramanica, K, Maliniak, M, et al. Nonfatal injuries 1 week after Hurricane Sandy – New York City Metropolitan Area, October 2012. MMWR Morb Mortal Wkly Rep. 2014;63(42):950-954.Google ScholarPubMed
3. Centers for Disease Control and Prevention. Deaths associated with Hurricane Sandy – October-November 2012. MMWR Morb Mortal Wkly Rep. 2013;62:393-397.Google Scholar
4. Teperman, S. Hurricane Sandy and the greater New York health care system. J Trauma Acute Care Surg. 2013;74(6):1401-1410. http://dx.doi.org/10.1097/TA.0b013e318296fa9f.CrossRefGoogle ScholarPubMed
5. Redlener, I, Reilly, MJ. Lessons from Sandy – preparing health systems for future disasters. N Engl J Med. 2012;367(24):2269-2271. http://dx.doi.org/10.1056/NEJMp1213486.Google Scholar
6. Sastry, N, Gregory, J. The effect of Hurricane Katrina on the prevalence of health impairments and disability among adults in New Orleans: differences by age, race, and sex. Soc Sci Med. 2013;80:121-129. http://dx.doi.org/10.1016/j.socscimed.2012.12.009.CrossRefGoogle ScholarPubMed
7. Mokdad, AH, Mensah, GA, Posner, SF, et al. When chronic conditions become acute: Prevention and control of chronic diseases and adverse health outcomes during natural disasters. Prev Chronic Dis [serial online]. 2005. http://www.cdc.gov/pcd/issues/2005/nov/05_0201.htm. Accessed September 28, 2015.Google Scholar
8. Goldmann, E, Galea, S. Mental health consequences of disasters. Annu Rev Public Health. 2014;35(1):169-183. http://dx.doi.org/10.1146/annurev-publhealth-032013-182435.Google Scholar
9. Davis, JR, Wilson, S, Brock-Martin, A, et al. The impact of disasters on populations with health and health care disparities. Disaster Med Public Health Prep. 2010;4(1):30-38. http://dx.doi.org/10.1017/S1935789300002391.Google Scholar
10. Runkle, JR, Brock-Martin, A, Karmaus, W, et al. Secondary surge capacity: a framework for understanding long-term access to primary care among medically vulnerable populations in disaster recovery. Am J Public Health. 2012;102(12):e24-e32. http://dx.doi.org/10.2105/AJPH.2012.301027.Google Scholar
11. Lin, C, Pierce, LC, Roblin, PM, et al. Impact of Hurricane Sandy on hospital emergency and dialysis services: a retrospective survey. Prehosp Disaster Med. 2014;29(4):374-379. http://dx.doi.org/10.1017/S1049023X14000715.Google Scholar
12. Platz, E, Cooper, HP, Silvestri, S, et al. The impact of a series of hurricanes on the visits to two central Florida emergency departments. J Emerg Med. 2007;33(1):39-46. http://dx.doi.org/10.1016/j.jemermed.2007.02.023.Google Scholar
13. Smith, CM, Graffeo, C. Regional impact of Hurricane Isabel on emergency departments in coastal southeastern Virginia. Acad Emerg Med. 2005;12(12):1201-1205. http://dx.doi.org/10.1111/j.1553-2712.2005.tb01498.x.Google Scholar
14. Rosendal, S, Mortensen, EL, Andersen, HS, et al. Use of health care services before and after a natural disaster among survivors with and without PTSD. Psychiatr Serv. 2014;65(1):91-97. http://dx.doi.org/10.1176/appi.ps.201200535.Google Scholar
15. Dorn, T, Yzermans, CJ, Kerssens, JJ, et al. Disaster and subsequent healthcare utilization: A longitudinal study among victims, their family members, and control subjects. Med Care. 2006;44(6):581-589. http://dx.doi.org/10.1097/01.mlr.0000215924.21326.37.Google Scholar
16. National Uniform Billing Committee. Official UB-04 Data Specification Manual 2012. Chicago: American Hospital Association; 2011.Google Scholar
17. Current Procedural Terminology. CPT 2015. Chicago: American Medical Association; 2014.Google Scholar
18. Centers for Medicare & Medicaid Services. HCPCS – General Information. https://www.cms.gov/Medicare/Coding/MedHCPCSGenInfo/index.html?redirect=/medhcpcsgeninfo/. Accessed October 29, 2015.Google Scholar
19. National Institute of Mental Health. Mental Health Medications. NIH website. http://www.nimh.nih.gov/health/topics/mental-health-medications/index.shtml. Last revised January 2016. Accessed April 19, 2016.Google Scholar
20. National Oceanic and Atmospheric Administration. Sea, Lake, and Overland Surges from Hurricanes (SLOSH). http://www.nhc.noaa.gov/surge/slosh.php. Accessed November 19, 2015.Google Scholar
21. Lawless, JF. Negative binomial and mixed Poisson regression. Can J Stat. 1987;15(3):209-225. http://dx.doi.org/10.2307/3314912.Google Scholar
22. Benjamini, Y, Hochberg, Y. Controlling the false discovery rate: A practical and powerful approach to multiple testing. J R Stat Soc B. 1995;57:289-300.Google Scholar
23. Glickman, ME, Rao, SR, Schultz, MR. False discovery rate control is a recommended alternative to Bonferroni-type adjustments in health studies. J Clin Epidemiol. 2014;67(8):850-857. http://dx.doi.org/10.1016/j.jclinepi.2014.03.012.Google Scholar
24. Puhani, PA. The treatment effect, the cross difference, and the interaction term in nonlinear difference-in-differences models. IZA Discussion Papers No. 3478. http://hdl.handle.net/10419/35150. Accessed February 12, 2016.Google Scholar
25. Powell, T, Hanfling, D, Gostin, LO. Emergency preparedness and public health: The Lessons of Hurricane Sandy [Published online November 16, 2012]. JAMA Online. doi: http://dx.doi.org/10.1001/jama.2012.108940. Accessed October 16, 2015.Google Scholar
26. Lane, K, Charles-Guzman, K, Wheeler, K, et al. Health effects of coastal storms and flooding in urban areas: a review and vulnerability assessment. J Environ Public Health. 2013(2013);913064. http://dx.doi.org/10.1155/2013/913064.Google Scholar
27. Schreiber, MD, Yin, R, Omaish, M, et al. Snapshot from Superstorm Sandy: American Red Cross mental health risk surveillance in Lower New York State. Ann Emerg Med. 2014;64(1):59-65. http://dx.doi.org/10.1016/j.annemergmed.2013.11.009.Google Scholar
28. Gibbs, LI, Holloway, CF. New York City After Action Report: Report and Recommendations to Mayor Michael R. Bloomberg. http://www.nyc.gov/html/recovery/downloads/pdf/sandy_aar_5.2.13.pdf. Published May 2013. Accessed February 11, 2016.Google Scholar
29. Shipp Hilts, A, Mack, S, Eidson, M, et al. New York State public health system response to Hurricane Sandy: an analysis of emergency reports [Published online December 2, 2015]. Disaster Med Public Health Prep. http://dx.doi.org/10.1017/dmp.2015.142.Google Scholar
30. Mortensen, K, Dreyfuss, Z. How many walked through the door? The effect of Hurricane Katrina evacuees on Houston emergency departments. Med Care. 2008;46(9):998-1001. http://dx.doi.org/10.1097/MLR.0b013e3181792573.Google Scholar
Supplementary material: File

Sharp supplementary material

Sharp supplementary material 1

Download Sharp supplementary material(File)
File 65 KB