Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-17T11:24:43.176Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  08 April 2013

Sundar S. Shrestha ,
Daniel M. Sosin  and
Martin I. Meltzer
Get access Rights & Permissions [Opens in a new window]

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)

Keywords

special medical carehospitalization ratehospital bed demandnursing home patientschronic medical conditions
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 6 , Issue 4 , December 2012 , pp. 335 - 341
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2012

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

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):27–32.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):174–182.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):1225–1230.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):1544–1546.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):1402–1408.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):158–160.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):426–432.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):56–61.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;20:267–275.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):2919–2920.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):232–241.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):933–939.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):2188–2190.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