Sue Anne Bell1,2, Theodore J Iwashyna2,3,4, Xingyu Zhang1, Bingxin Chen1, Matthew A Davis1,2,5. 1. Department of Systems, Populations, and Leadership, University of Michigan School of Nursing, Ann Arbor, MichiganUSA. 2. Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MichiganUSA. 3. University of Michigan Medical School, Department of Internal Medicine, Ann Arbor, MichiganUSA. 4. Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MichiganUSA. 5. Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MichiganUSA.
Abstract
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.
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.
Entities:
Keywords:
delivery of health care; disaster; disaster preparedness; older adults
Authors: Hallie C Prescott; Robert P Dickson; Mary A M Rogers; Kenneth M Langa; Theodore J Iwashyna Journal: Am J Respir Crit Care Med Date: 2015-09-01 Impact factor: 21.405