Jhung Michael A, Shehab Nadine, Rohr-Allegrini Cherise, Pollock Daniel A, Sanchez Roger, Guerra Fernando, Jernigan Daniel B
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Am J Prev Med. 2007 Sep;33(3):207-10. doi: 10.1016/j.amepre.2007.04.030.
Preparing for natural disasters has historically focused on treatment for acute injuries, environmental exposures, and infectious diseases. Many disaster survivors also have existing chronic illness, which may be worsened by post-disaster conditions. The relationship between actual medication demands and medical relief pharmaceutical supplies was assessed in a population of 18,000 evacuees relocated to San Antonio TX after Hurricane Katrina struck the Gulf Coast in August 2005.
Healthcare encounters from day 4 to day 31 after landfall were monitored using a syndromic surveillance system based on patient chief complaint. Medication-dispensing records were collected from federal disaster relief teams and local retail pharmacies serving evacuees. Medications dispensed to evacuees during this period were quantified into defined daily doses and classified as acute or chronic, based on their primary indications.
Of 4,229 categorized healthcare encounters, 634 (15%) were for care of chronic medical conditions. Sixty-eight percent of all medications dispensed to evacuees were for treatment of chronic diseases. Cardiovascular medications (39%) were most commonly dispensed to evacuees. Thirty-eight percent of medication doses dispensed by federal relief teams were for chronic care, compared to 73% of doses dispensed by retail pharmacies. Federal disaster relief teams supplied 9% of all chronic care medicines dispensed.
A substantial demand for drugs used to treat chronic medical conditions was identified among San Antonio evacuees, as was a reliance on retail pharmacy supplies to meet this demand. Medical relief pharmacy supplies did not consistently reflect the actual demands of evacuees.
历史上，自然灾害应对工作主要集中在急性损伤、环境暴露和传染病的治疗上。许多灾难幸存者还患有慢性疾病，这些疾病可能会因灾后状况而恶化。2005年8月卡特里娜飓风袭击墨西哥湾沿岸后，对18000名撤离到得克萨斯州圣安东尼奥的受灾民众的实际用药需求与医疗救援药品供应之间的关系进行了评估。
使用基于患者主要诉求的症状监测系统，对登陆后第4天至第31天的医疗接触情况进行监测。从联邦救灾团队和为撤离人员服务的当地零售药店收集药品分发记录。在此期间分发给撤离人员的药品，根据其主要适应症，按限定日剂量进行量化，并分为急性或慢性用药。
在4229次分类医疗接触中，634次（15%）是针对慢性疾病护理的。分发给撤离人员的所有药品中，68%用于治疗慢性病。心血管药物（39%）是最常分发给撤离人员的药物。联邦救灾团队分发的药物剂量中有38%用于慢性病护理，而零售药店分发的这一比例为73%。联邦救灾团队提供了所有分发的慢性病护理药品的9%。
在圣安东尼奥的撤离人员中，发现对用于治疗慢性疾病的药物有大量需求，并且依赖零售药店供应来满足这一需求。医疗救援药品供应并未始终反映撤离人员的实际需求。
