Health Care Utilization Among Texas Veterans Health Administration Enrollees Before and After Hurricane Harvey, 2016-2018

Abstract

Key Points Question Was residential flooding due to Hurricane Harvey in August 2017 associated with health care utilization among veterans in Texas? Findings This cohort study including 99 858 patients found greater and longer lasting declines in primary care visits, emergency department visits, and inpatient admissions among veterans with flooded residences, racial minority veterans, and low-income veterans. Meaning These findings suggest that veteran patients most exposed to Hurricane Harvey also had the greatest delay in or nonreceipt of health care.

Impacts of Hurricane Matthew Exposure on Infections and Antimicrobial Prescribing in North Carolina Veterans

“…The increase in antimicrobial prescribing observed in weeks 3þ could be due to an onset of less acute infections resulting from hurricane exposure or reflect a delay and then rebound in healthcare seeking behavior as the hurricane disrupted typical activities, as has been previously observed in VHA users. 4 The delayed healthcare seeking behavior is also potentially responsible for the relative decline in outpatient visits for infections in weeks 0-2 versus the baseline period. Taken together, hurricane and flood exposure appear to have had minor impacts on infectious outcomes in North Carolina veterans, not resulting in large increases in infections or antimicrobial prescribing.…”

Trends in Routine Checkup Within the Past Year Following a Hurricane

“…10 Our findings are consistent with studies that have examined specific hurricanes or areas and documented disruptions in access to care. [5][6][7][8] The long-term impact on disruptions to routine care associated with disasters, such as delayed diagnosis and treatment of chronic disease, warrant further investigation.…”

“…Studies have found that healthcare access following natural disasters has been linked with decreased access to health care. [5][6][7][8] Most of the research has examined the effect of 1 disaster on 1 specific region, but there is limited evidence comparing the effects of hurricanes on access to care for different regions. Therefore, this study compared the effect of hurricanes on routine checkup by states that had a major hurricane (category 3-5) make landfall versus states that were impacted by a category 1-2 hurricane.…”

Hurricane Harvey and the risk of spontaneous preterm and early-term birth

“…20 , 21 Declines in overall health care utilization, including primary care practitioner visits, emergency department visits, and hospitalizations, were observed during and post-Hurricane Harvey, indicating barriers to care. 22 However, emergency department visits for carbon monoxide poisoning, insect bite, dehydration, hypothermia, pregnancy complications, and hospitalizations for respiratory and infectious diseases and injuries increased. 23 , 24 A prior study of one public and one private hospital in Houston found that births occurring within 40 weeks of Harvey’s landfall were more likely to have adverse maternal (e.g., cesarean section and hypertensive disorders of pregnancy) and neonatal (e.g., respiratory distress syndrome and newborn sepsis) outcomes.…”