Dunlop Anne Lang, Isakov Alexander P, Compton Michael T, White Melissa, Nassery Hogai, Frank Erica, Glanz Karen
Department of Family & Preventive Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Am J Disaster Med. 2007 May-Jun;2(3):121-32.
In the aftermath of Hurricane Katrina, many individuals were evacuated to the Atlanta area (1,306 medical evacuees, over 100,000 self-evacuees), placing considerable strain on an already overburdened healthcare system. With the aim of improving future disaster responsiveness, we designed this in-depth case study to identify systemic vulnerabilities and gaps in community responsiveness to an influx of evacuees from a remote disaster. Qualitative methods were used to interview key informants both individually and in focus groups. Coding and content analysis of transcribed interview data were used to identify shared observations and common themes. Twenty-three individuals in leadership roles at the Woodruff Health Sciences Center of Emory University or the Grady Health System completed individual interviews; an additional 24 healthcare providers participated in focus groups. A strategy-based data-coding scheme for interview data was used to identify key foci, including services that met needs of evacuees, unmet needs, service provision that was successful/unsuccessful, underlying reasons for success or failure, and future needs for disaster planning and responsiveness. Analysis of interview data revealed important accomplishments and deficits in the medical community's response in specific domains of community disaster planning and evaluation. For each key component of community disaster planning and evaluation, there are considerations at the institutional, regional, state, and federal levels. In the current study, these considerations were identified as instrumental in effectively meeting the healthcare needs of the evacuated population.
卡特里娜飓风过后，许多人被疏散到亚特兰大地区（1306名医疗疏散人员，超过10万名自行疏散人员），这给本就不堪重负的医疗系统带来了巨大压力。为了提高未来对灾难的应对能力，我们设计了这个深入的案例研究，以确定社区在应对来自偏远地区灾难的疏散人员涌入时的系统脆弱性和差距。采用定性方法，分别对关键信息提供者进行了单独访谈，并组织了焦点小组访谈。对转录的访谈数据进行编码和内容分析，以确定共同的观察结果和共同主题。埃默里大学伍德拉夫健康科学中心或格雷迪健康系统的23名担任领导职务的人员完成了个人访谈；另外24名医疗服务提供者参加了焦点小组访谈。采用基于策略的访谈数据编码方案来确定关键重点，包括满足疏散人员需求的服务、未满足的需求、成功/失败的服务提供情况、成功或失败的根本原因，以及未来灾难规划和应对的需求。对访谈数据的分析揭示了医疗界在社区灾难规划和评估的特定领域的应对中取得的重要成就和存在的不足。对于社区灾难规划和评估的每个关键组成部分，在机构、区域、州和联邦层面都有需要考虑的因素。在本研究中，这些因素被确定为有效满足疏散人群医疗需求的关键因素。
