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经历桑迪飓风带来的恐惧或困扰一年后老年人的医疗保健利用情况。

Older Adults' Health Care Utilization a Year After Experiencing Fear or Distress from Hurricane Sandy.

作者信息

Sands Laura P, Xie Yimeng, Pruchno Rachel, Heid Allison, Hong Yili

机构信息

1Center for Gerontology,Virginia Tech,Blacksburg,Virginia.

2Department of Statistics,Virginia Tech,Blacksburg,Virginia.

出版信息

Disaster Med Public Health Prep. 2018 Oct;12(5):578-581. doi: 10.1017/dmp.2017.134. Epub 2018 Feb 5.

DOI:10.1017/dmp.2017.134
PMID:29397807
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6077111/
Abstract

OBJECTIVE

To determine whether self-reports of disaster-related psychological distress predict older adults' health care utilization during the year after Hurricane Sandy, which hit New Jersey on October 29, 2012.

METHODS

Respondents were from the ORANJ BOWL Study, a random-digit dialed sample from New Jersey recruited from 2006 to 2008. Medicare hospital, emergency department (ED) and outpatient claims data from 2012 and 2013 were matched to 1607 people age 65 and older in 2012 who responded to follow-up surveys conducted from July 2013 to July 2015 to determine their hurricane-related experiences.

RESULTS

In total, 7% (107) of respondents reported they experienced a lot versus 93% (1493) respondents reported they experienced little or no fear and distress from Hurricane Sandy. Those who experienced a lot versus little or no fear and distress had higher probability of all-cause hospital admissions and more ED visits through 3 months (hazard ratio [HR]: 2.19, 95% CI: 1.03-4.63; incidence ratio [IR]: 2.57, 95% CI: 1.21-5.35), and ED and outpatient visits (IR: 2.20, 95% CI: 1.44-3.37; IR: 1.37, 95% CI: 1.02-1.87) through the year after the hurricane.

CONCLUSIONS

A self-reported assessment of disaster-related psychological distress is a strong predictor of older adults' health care needs the year after the disaster. The results indicate that disaster preparedness should extend beyond acute health care needs to address longer-term health consequences of disasters. (Disaster Med Public Health Preparedness. 2018;12:578-581).

摘要

目的

确定与灾难相关的心理困扰的自我报告是否能预测2012年10月29日袭击新泽西州的桑迪飓风过后一年内老年人的医疗服务利用情况。

方法

受访者来自ORANJ BOWL研究，这是一个2006年至2008年从新泽西州随机拨号抽取的样本。2012年和2013年的医疗保险医院、急诊科（ED）和门诊索赔数据与2012年1607名65岁及以上的人相匹配，这些人在2013年7月至2015年7月期间接受了后续调查，以确定他们与飓风相关的经历。

结果

总体而言，7%（107）的受访者报告称他们经历了很多，而93%（1493）的受访者报告称他们几乎没有或没有因桑迪飓风而感到恐惧和困扰。经历很多恐惧和困扰的人与几乎没有或没有恐惧和困扰的人相比，在3个月内全因住院的可能性更高，急诊就诊次数更多（风险比[HR]：2.19，95%置信区间：1.03 - 4.63；发病率比[IR]：2.57，95%置信区间：1.21 - 5.35），并且在飓风过后的一年中急诊和门诊就诊次数也更多（IR：2.20，95%置信区间：1.44 - 3.37；IR：1.37，95%置信区间：1.02 - 1.87）。

结论

与灾难相关的心理困扰的自我报告评估是灾难过后一年内老年人医疗需求的有力预测指标。结果表明，灾难准备应超越急性医疗需求，以应对灾难的长期健康后果。（《灾难医学与公共卫生防范》。2018年；12：578 - 581）