Principal Environmental Public Health Scientist, Extreme Events and Health Protection, Public Health England, UK.
Research Fellow, NIHR Health Protection Research Unit in Environmental Change and Health, London School of Hygiene and Tropical Medicine, UK.
J Health Serv Res Policy. 2019 Oct;24(4):219-228. doi: 10.1177/1355819619840672. Epub 2019 Jul 23.
Our objective was to assess the health care system impacts associated with the December 2013 east coast flooding in Boston, Lincolnshire, in order to gain an insight into the capacity of the health care sector to respond to high-impact weather.
Semistructured interviews were held with regional strategic decision makers and local service managers within 1 km of the recorded flood outline to ascertain their experiences, views and reflections concerning the event and its associated health impacts and disruption to health care services. A snowballing sampling technique was used to ensure the study had participants across a broad range of expertise. Interviews were recorded and transcribed verbatim, and data analysis was preformed using NVivo (v10) to apply a thematic coding and develop a framework of ideas.
The results of this case study provide a vital insight into the health care disruption caused by flooding. All sectors of the health care system suffered disruption, which placed a strain on the whole system and reduced the capacity of the sector to respond to the health consequences of flooding and delivering routine health care. The formal recovery phase in Lincolnshire was stood-down on 4th February 2014. The results of this work indicate limitations in preparedness of the health care system for the reasonable worse-case scenario for an east coast surge event.
The health care sector appears to have limited capacity to respond to weather-related impacts and is therefore unprepared for the risks associated with a future changing climate. Further work is required to ensure that the health care system continues to review and learn from such events to increase climate resilience.
我们的目的是评估与 2013 年 12 月波士顿林肯郡东海岸洪灾相关的医疗系统影响，以便深入了解医疗部门应对高强度天气的能力。
在距记录洪灾范围 1 公里内，对区域战略决策者和当地服务经理进行半结构化访谈，以了解他们对该事件及其相关健康影响和医疗服务中断的经验、观点和反思。采用滚雪球抽样技术，确保研究对象涵盖广泛的专业知识。对访谈进行录音并逐字记录，使用 NVivo（v10）进行数据分析，采用主题编码并制定思路框架。
本案例研究的结果深入了解了洪水对医疗的破坏。医疗系统的所有部门都受到了干扰，这给整个系统带来了压力，降低了该部门应对洪水健康后果和提供常规医疗的能力。2014 年 2 月 4 日，林肯郡的正式恢复阶段结束。这项工作的结果表明，医疗系统对东海岸浪涌事件的最坏情况的准备存在局限性。
医疗部门似乎应对与天气相关的影响的能力有限，因此对未来气候变化带来的风险毫无准备。需要进一步努力确保医疗系统继续审查和吸取此类事件的经验教训，以提高气候适应能力。
