Citation

Malik S, Lee DC, Doran KM, Grudzen CR, Worthing J, Portelli I, Goldfrank LR, Smith SW. Disaster Med. Public Health Prep. 2018; 12(2): 184-193.

Affiliation

Ronald O. Perelman Department of Emergency Medicine,New York University School of Medicine,New York,New York.

Copyright

(Copyright © 2018, Society for Disaster Medicine and Public Health, Publisher Cambridge University Press)

DOI

10.1017/dmp.2017.44

PMID

28766475

Abstract

OBJECTIVE: Older adults are a potentially medically vulnerable population with increased mortality rates during and after disasters. To evaluate the impact of a natural disaster on this population, we performed a temporal and geospatial analysis of emergency department (ED) use by adults aged 65 years and older in New York City (NYC) following Hurricane Sandy's landfall.

METHODS: We used an all-payer claims database to analyze demographics, insurance status, geographic distribution, and health conditions for post-disaster ED visits among older adults. We compared ED patterns of use in the weeks before and after Hurricane Sandy throughout NYC and the most afflicted evacuation zones.

RESULTS: We found significant increases in ED utilization by older adults (and disproportionately higher in those aged ≥85 years) in the 3 weeks after Hurricane Sandy, especially in NYC evacuation zone one. Primary diagnoses with notable increases included dialysis, electrolyte disorders, and prescription refills. Secondary diagnoses highlighted homelessness and care access issues.

CONCLUSIONS: Older adults display heightened risk for worse health outcomes with increased ED visits after a disaster. Our findings suggest the need for dedicated resources and planning for older adults following a natural disaster by ensuring access to medical facilities, prescriptions, dialysis, and safe housing and by optimizing health care delivery needs to reduce the burden of chronic disease. (Disaster Med Public Health Preparedness. 2017;page 1 of 10).

Language: en

Keywords

disaster management; emergency department; geographic information systems; older adults; vulnerable populations