Agency for Healthcare Research and Quality, Rockville, Maryland.
The George Washington University, Milken Institute School of Public Health, Department of Epidemiology, Washington D.C.
Disaster Med Public Health Prep. 2021 Dec;15(6):762-769. doi: 10.1017/dmp.2020.281. Epub 2020 Oct 7.
Emergency departments (EDs) are critical sources of care after natural disasters such as hurricanes. Understanding the impact on ED utilization by subpopulation and proximity to the hurricane's path can inform emergency preparedness planning. This study examines changes in ED utilization for residents of 344 counties after the occurrence of 7 US hurricanes between 2005 and 2016.
This retrospective observational study used ED data from the Healthcare Cost and Utilization Project State Inpatient Databases and State Emergency Department Databases. ED utilization rates for weeks during and after hurricanes were compared with pre-hurricane rates, stratified by the proximity of the patient county to the hurricane path, age, and disease category.
The overall population rate of weekly ED visits changed little post-hurricane, but rates by disease categories and age demonstrated varying results. Utilization rates for respiratory disorders exhibited the largest post-hurricane increase, particularly 2-3 weeks following the hurricane. The change in population rates by disease categories and age tended to be larger for people residing in counties closer to the hurricane path.
Changes in ED utilization following hurricanes depend on disease categories, age, and proximity to the hurricane path. Emergency managers could incorporate these factors into their planning processes.
急诊部(ED)是飓风等自然灾害后重要的医疗来源。了解亚人群和靠近飓风路径对 ED 使用的影响,可以为应急准备规划提供信息。本研究调查了 2005 年至 2016 年期间美国 7 次飓风发生后 344 个县居民 ED 使用量的变化。
本回顾性观察研究使用了医疗保健成本和利用项目州住院数据库和州急诊部数据库中的 ED 数据。将飓风期间和之后几周的 ED 使用率与飓风前的比率进行比较,按患者所在县与飓风路径的接近程度、年龄和疾病类别进行分层。
飓风后,整体人群每周 ED 就诊率变化不大,但各疾病类别和年龄的就诊率则呈现不同的结果。呼吸系统疾病的就诊率在飓风后增加最大,特别是在飓风过后 2-3 周。疾病类别和年龄的人群变化率往往在靠近飓风路径的县更大。
飓风后 ED 使用量的变化取决于疾病类别、年龄和靠近飓风路径的程度。应急管理人员可以将这些因素纳入其规划过程。