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Hospitalizations for chronic conditions following hurricanes among older adults: A self-controlled case series analysis.
Bell, Sue Anne; Donnelly, John P; Li, Wang; Davis, Matthew A.
Affiliation
  • Bell SA; University of Michigan School of Nursing, Ann Arbor, Michigan, USA.
  • Donnelly JP; University of Michigan School of Medicine, Ann Arbor, Michigan, USA.
  • Li W; University of Michigan School of Nursing, Ann Arbor, Michigan, USA.
  • Davis MA; University of Michigan School of Nursing, Ann Arbor, Michigan, USA.
J Am Geriatr Soc ; 70(6): 1695-1703, 2022 06.
Article in En | MEDLINE | ID: mdl-35171505
ABSTRACT
BACKGROUND/

PURPOSE:

Extreme events such as hurricanes adversely impact healthcare systems and the communities they serve. The degree to which hurricanes affect healthcare use among high need groups such as older adults with chronic conditions has not been well examined, nor has the impact of hurricane severity on health outcomes. We characterized hospitalizations among older adults by chronic condition after eight large-scale hurricanes in the United States.

METHODS:

Using a combination of administrative healthcare data and the Federal Emergency Management Agency's Disaster Declaration database we conducted a self-controlled case series analysis. We identified Medicare beneficiaries who were exposed to one of eight hurricanes and compared hospitalizations in the 30-days after a hurricane to hospitalizations in the rest of the calendar year of the hurricane. We examined hospitalizations (1) in total, (2) separately for diabetes, congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD) admissions, and (3) by hurricane damage category.

RESULTS:

Among all older adults exposed, hospitalizations in the 30-day period after each disaster increased for all three chronic conditions; diabetes (incidence rate ratio [IRR] = 1.06, 95% confidence interval [CI] 1.03, 1.10), COPD (IRR = 1.06, 95% CI 1.04, 1.08), and CHF (IRR = 1.19, 95% CI 1.17, 1.21. In the 30-to-60-day period hospitalizations also increased for each chronic condition; diabetes (IRR = 1.06, 95% CI 1.03, 1.10), COPD (IRR = 1.12, 95% CI 1.10, 1.15), and CHF (IRR = 1.32, 95% CI 1.30, 1.34). Substantial differences in hospitalizations were observed according to individual hurricane and by the chronic disease examined.

CONCLUSION:

Exposure to hurricanes is associated with an increase in hospitalizations for chronic conditions across all hurricane damage categories. As disasters are expected to increase in strength and frequency, our results underscore the need for response strategies and health policy planning for healthcare systems designed to address the health needs of older Americans with chronic conditions.
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Full text: 1 Collection: 01-internacional Health context: 1_ASSA2030 / 2_ODS3 Database: MEDLINE Main subject: Pulmonary Disease, Chronic Obstructive / Cyclonic Storms / Heart Failure Limits: Aged / Humans Country/Region as subject: America do norte Language: En Journal: J Am Geriatr Soc Year: 2022 Document type: Article

Full text: 1 Collection: 01-internacional Health context: 1_ASSA2030 / 2_ODS3 Database: MEDLINE Main subject: Pulmonary Disease, Chronic Obstructive / Cyclonic Storms / Heart Failure Limits: Aged / Humans Country/Region as subject: America do norte Language: En Journal: J Am Geriatr Soc Year: 2022 Document type: Article