Emergency Department Visits by and Hospitalizations of Senior Diabetics in the Three Years Following Hurricanes Katrina and Rita

Quast, Troy

doi:10.1007/s41885-019-0039-8

Cited by 5 publications

(6 citation statements)

References 17 publications

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“…2 Elevations in postdisaster geriatric emergency department visits 15 and cardiac events 16 were seen after Hurricane Sandy, and also in a combined study looking at Hurricanes Rita and Katrina. 3,17 This study also found significant increases in all-cause hospital admissions when examining eight separate, large-scale hurricanes. Prior research has described surges in hospitalization after hurricanes, however most of these reports have been limited to one disaster 18 or the immediate period after a disaster.…”

Section: Discussionsupporting

confidence: 52%

All-Cause Hospitalizations after Large-Scale Hurricanes among Older Adults: A Self-Controlled Case Series Study

Bell

Iwashyna

Zhang

et al. 2020

Prehosp. Disaster med.

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Introduction: Understanding the drivers of health care utilization patterns following disasters can better support health planning. This study characterized all-cause hospitalizations among older Americans after eight large-scale hurricanes. Study Objective: The objective of this study was to characterize all-cause hospitalizations for any cause among older Americans in the 30 days after eight large-scale hurricanes. Methods: A self-controlled case series study among Medicare beneficiaries (age 65+) exposed to one of eight hurricanes was conducted. The predicted probability of sociodemographic factors associated with hospitalization using logit models was estimated. Results: Hurricane Sandy (2012) had the highest post-hurricane admission rate, a 23% increase (incidence rate ratio [IRR] = 1.23; 95% CI, 1.22-1.24), while Hurricane Irene in 2011 had only a 10% increase (IRR = 1.10; 95% CI, 1.09-1.11). Higher likelihood of hospitalization occurring after hurricanes included being 85 or older (36.8% probability of hospitalization; 95% CI, 34.7-39.0) and being dually eligible for Medicare and Medicaid (62.8%; 95% CI, 60.7-64.9). Conclusion: Planning to address the surge in hospitalization for a longer time period after hurricanes and interventions targeted to support aging Americans are needed.

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Section: Discussionsupporting

confidence: 52%

All-Cause Hospitalizations after Large-Scale Hurricanes among Older Adults: A Self-Controlled Case Series Study

Bell

Iwashyna

Zhang

et al. 2020

Prehosp. Disaster med.

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“…Our strategy intentionally over-sampled (up to 50%) those with Black and/or African American racial, biracial or multiracial identities as a novel strategy to combat racial data bias and develop a survey based on the population with the greatest demonstrated disparity for disaster-related assessment outcomes at the household level. (3, 4) Cognitive interviewing is generally conducted with 10 participants(2). We intentionally doubled this sample size in order to include a full cognitive interviewing sample size panel of those with Black and/or African American racial identities.…”

Section: Qualitative Approach and Research Paradigmmentioning

confidence: 99%

“…Rising global surface temperatures increase the risk for and severity of droughts, floods, storms and other forms of severe weather and natural hazards (2). In the United States, weather and climate disasters are increasing in frequency and severity, responsible for over 13,000 deaths, $1.75 trillion additional costs, and worsened morbidity over the last 40 years (3)(4)(5). In 2021, the Centre for Research on the Epidemiology of Disaster (CRED) recorded an increase in the annual number of recorded global disasters (432 disasters in 2021 vs. previous 20 year annual average of 357) (6).…”

Section: Introductionmentioning

confidence: 99%

Cognitive Interview Validation of a Novel Household Hazard Vulnerability Assessment Instrument

Amberson

Ndayishimiye

Cloud

et al. 2022

Preprint

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Background Weather and climate disasters are responsible for over 13,000 USA deaths, worsened morbidity, and $1.7 trillion additional costs over the last 40 years with profound racial disparities. This project empirically generated items for a novel survey instrument of household hazard vulnerability with initial construct validation while addressing racial data bias. Methods Cognitive interviewing methodology was completed with transdisciplinary disaster expert panelists (n=20) from diverse USA regions on 60 unique hazard, disaster, or event items. Interview video recordings were qualitatively analyzed using thematic and pattern coding. Results A cognitive process mapped to themes of disaster characteristics, resources, individual life facet, and felt effect was revealed. 379 unique instances of linked terms as synonyms, co-occurring, compounding, or cascading events were identified. Potential for racial data bias was elucidated. Analysis of radiation exposure, trauma, criminal acts of intent items revealed participants may not interpret survey items with these terms as intended. Discussion The findings indicate the potential for racial data bias relative to water dam failure, evacuation, external flood, suspicious package/substance, and transportation failure. Hazard terms that were not interpreted as intended require further revision in the validation process of individual or household disaster vulnerability assessments. Conclusion Several commonalities in the cognitive process and mapping of disaster terms may be utilized in disaster and climate change research aimed at the individual and household unit of analysis. Keywords: racial bias; survey and questionnaire development; validation studies; disasters; environment and public health; hazard analysis

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“…7 Connecting these data to disaster events represents a logical application to understanding resulting morbidity and mortality, however, there exist only a handful of studies that have done so. [8][9][10][11][12] We conducted a self-controlled case series to address this gap and to determine the associations of hurricane events with hospitalizations for chronic conditions among older adults in the US. Specifically, we characterized admissions for chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), and diabetes among Medicare beneficiaries following several largescale hurricanes in the United States.…”

Section: Introductionmentioning

confidence: 99%

“…The overwhelming majority of older Americans have Medicare insurance, where analyses of Medicare data have been considered essential to informing healthcare, and to guide healthcare policy 7 . Connecting these data to disaster events represents a logical application to understanding resulting morbidity and mortality, however, there exist only a handful of studies that have done so 8–12 …”

Section: Introductionmentioning

confidence: 99%

Hospitalizations for chronic conditions following hurricanes among older adults: A self‐controlled case series analysis

Bell

Donnelly

et al. 2022

J American Geriatrics Society

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Background/Purpose Extreme events such as hurricanes adversely impact healthcare systems and the communities they serve. The degree to which hurricanes affect healthcare use among high need groups such as older adults with chronic conditions has not been well examined, nor has the impact of hurricane severity on health outcomes. We characterized hospitalizations among older adults by chronic condition after eight large‐scale hurricanes in the United States. Methods Using a combination of administrative healthcare data and the Federal Emergency Management Agency's Disaster Declaration database we conducted a self‐controlled case series analysis. We identified Medicare beneficiaries who were exposed to one of eight hurricanes and compared hospitalizations in the 30‐days after a hurricane to hospitalizations in the rest of the calendar year of the hurricane. We examined hospitalizations (1) in total, (2) separately for diabetes, congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD) admissions, and (3) by hurricane damage category. Results Among all older adults exposed, hospitalizations in the 30‐day period after each disaster increased for all three chronic conditions; diabetes (incidence rate ratio [IRR] = 1.06, 95% confidence interval [CI] 1.03, 1.10), COPD (IRR = 1.06, 95% CI 1.04, 1.08), and CHF (IRR = 1.19, 95% CI 1.17, 1.21. In the 30‐to‐60‐day period hospitalizations also increased for each chronic condition; diabetes (IRR = 1.06, 95% CI 1.03, 1.10), COPD (IRR = 1.12, 95% CI 1.10, 1.15), and CHF (IRR = 1.32, 95% CI 1.30, 1.34). Substantial differences in hospitalizations were observed according to individual hurricane and by the chronic disease examined. Conclusion Exposure to hurricanes is associated with an increase in hospitalizations for chronic conditions across all hurricane damage categories. As disasters are expected to increase in strength and frequency, our results underscore the need for response strategies and health policy planning for healthcare systems designed to address the health needs of older Americans with chronic conditions.

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Emergency Department Visits by and Hospitalizations of Senior Diabetics in the Three Years Following Hurricanes Katrina and Rita

Cited by 5 publications

References 17 publications

All-Cause Hospitalizations after Large-Scale Hurricanes among Older Adults: A Self-Controlled Case Series Study

All-Cause Hospitalizations after Large-Scale Hurricanes among Older Adults: A Self-Controlled Case Series Study

Cognitive Interview Validation of a Novel Household Hazard Vulnerability Assessment Instrument

Hospitalizations for chronic conditions following hurricanes among older adults: A self‐controlled case series analysis

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