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卡特里娜飓风对患有慢性疾病幸存者护理工作的影响。

Hurricane Katrina's impact on the care of survivors with chronic medical conditions.

作者信息

Kessler Ronald C

机构信息

Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, Massachusetts 02115, USA.

出版信息

J Gen Intern Med. 2007 Sep;22(9):1225-30. doi: 10.1007/s11606-007-0294-1. Epub 2007 Jul 27.

Abstract

BACKGROUND

Hurricane Katrina affected a population with significant levels of chronic disease.

OBJECTIVE

The extent to which Hurricane Katrina disrupted treatments is not known but would be useful information for future disaster planning.

PARTICIPANTS

1,043 displaced and nondisplaced English-speaking Katrina survivors ages 18 and older who resided in affected areas before the hurricane.

DESIGN AND SETTING

A geographically representative telephone survey conducted between January 19 and March 31, 2006.

MEASUREMENTS AND MAIN RESULTS

The proportions of survivors with chronic illnesses in the 12 months before the hurricane and the extent to which those with chronic illnesses cut back or terminated treatments because of the disaster. Correlates and reasons given by survivors for disrupted treatment were identified. Most (73.9%) Katrina survivors had 1 or more chronic conditions in the year before the hurricane; of these, 20.6% cut back or terminated their treatment because of the disaster. Disruptions in treatment were significantly more common among the non-elderly, uninsured, socially isolated, those with housing needs, or for conditions remaining relatively asymptomatic but still dangerous if untreated. Frequent reasons for disrupted care included problems accessing physicians (41.1%), medications (32.5%), insurance/financial means (29.3%), transportation (23.2%), or competing demands on time (10.9%).

CONCLUSIONS

Many Katrina survivors burdened by chronic disease had their treatments disrupted by the disaster. Future disaster management plans should anticipate and address such chronic care needs, with timely reestablishment of primary care services, access to medications, and means to address financial and structural barriers to treatment.

摘要

背景

卡特里娜飓风影响了患有大量慢性病的人群。

目的

卡特里娜飓风对治疗造成的干扰程度尚不清楚,但这将为未来的灾难规划提供有用信息。

参与者

1043名18岁及以上的流离失所和未流离失所的英语使用者卡特里娜飓风幸存者,他们在飓风来临前居住在受灾地区。

设计与环境

2006年1月19日至3月31日进行的具有地理代表性的电话调查。

测量与主要结果

飓风来临前12个月内患有慢性病的幸存者比例,以及患有慢性病的人因灾难而减少或终止治疗的程度。确定了幸存者治疗中断的相关因素和原因。大多数(73.9%)卡特里娜飓风幸存者在飓风来临前一年患有1种或更多慢性病;其中,20.6%的人因灾难而减少或终止了治疗。在非老年人、未参保者、社会孤立者、有住房需求者中,或者对于那些症状相对不明显但不治疗仍有危险的疾病,治疗中断更为常见。护理中断的常见原因包括看医生困难(41.1%)、药物问题(32.5%)、保险/经济手段问题(29.3%)、交通问题(23.2%)或时间安排冲突(10.9%)。

结论

许多负担着慢性病的卡特里娜飓风幸存者的治疗因灾难而中断。未来的灾难管理计划应预测并解决此类慢性病护理需求,及时恢复初级保健服务、提供药物,并解决治疗的经济和结构障碍。

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