@article{ref1,
title="A positive legacy of trauma? A study on the impact of natural disasters on medical utilization",
journal="International journal for quality in health care",
year="2019",
author="Iqbal, Usman and Li, Yu-Chuan Jack and Tang, Kung-Pei and Chien, Hui-Chen and Yang, Ya-Ting and Hsu, Yi-Hsin Elsa",
volume="31",
number="1",
pages="64-69",
abstract="OBJECTIVE: The impact of natural disasters on medical utilization is largely unknown and often overlooked how it affects bereaving and non-bereaving survivors. The aim of this study is to determine the medical utilization between both survivor groups and long-term effects. STUDY DESIGN: A 10-year 1999-2009 population-based retrospective study by using the National Health Insurance claim database and the Household Registration database from the Department of Health, Executive Yuan, Taiwan. SETTINGS: Taiwan 1999 Chi-Chi earthquake-affected areas. PARTICIPANTS: A total of 49 834 individuals which included 1183 bereaving survivors and 48 651 non-bereaving earthquake survivors. INTERVENTION(S): None. MAIN OUTCOME MEASURES: Medical utilization of bereaving and non-bereaving survivors. <br><br>RESULTS: The results showed that bereaving survivors had significantly more outpatient visits before the earthquake, within 3-month period and 1 year after earthquake (odds ratio (OR) = 1.11, 1.16 and 1.08). However, after 1 year after earthquake their outpatient visits were not significantly different from non-bereaving, and even significantly less in some years. Inpatient visits of bereaving survivors had similar trend to outpatient visits, i.e. visits were more both before earthquake and within 3-month period after earthquake (OR = 1.59 and 1.89), however, they were not significantly higher than non-bereaving survivors for the following years of the study. <br><br>CONCLUSION: Our study reveals that compared to non-bereaving survivors, bereaving survivors slightly had higher medical utilization in the beginning stage of earthquake, i.e. for the first 3-month period or 1 year after earthquake. However, there were no differences between these two groups in medical utilization including outpatient and inpatient visits in long run.<p /> <p>Language: en</p>",
language="en",
issn="1353-4505",
doi="10.1093/intqhc/mzy130",
url="http://dx.doi.org/10.1093/intqhc/mzy130"
}