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The Medical Home and Care Coordination in Disaster Recovery: Hypothesis for Interventions and Research

Published online by Cambridge University Press:  05 June 2015

Robert K. Kanter ,
David M. Abramson ,
Irwin Redlener  and
Delaney Gracy
Robert K. Kanter*
Affiliation:
National Center for Disaster Preparedness, Earth Institute, Columbia University, New York, NY Virginia Tech Carilion School of Medicine, Roanoke, Va, and SUNY Upstate Medical University, Syracuse, NY
David M. Abramson
Affiliation:
National Center for Disaster Preparedness, Earth Institute, Columbia University, New York, NY New York University, NY, NY
Irwin Redlener
Affiliation:
National Center for Disaster Preparedness, Earth Institute, Columbia University, New York, NY Children’s Health Fund, New York, NY
Delaney Gracy
Affiliation:
Children’s Health Fund, New York, NY
*
Correspondence and reprint requests to Robert K. Kanter, MD, National Center for Disaster Preparedness, Earth Institute, Columbia University, 215 W 125th St, 3rd floor, NY, NY 10027 (e-mail: rkk2117@columbia.edu).
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Abstract

In postdisaster settings, health care providers encounter secondary surges of unmet primary care and mental health needs that evolve throughout disaster recovery phases. Whatever a community’s predisaster adequacy of health care, postdisaster gaps are similar to those of any underserved region. We hypothesize that existing practice and evidence supporting medical homes and care coordination in primary care for the underserved provide a favorable model for improving health in disrupted communities. Elements of medical home services can be offered by local or temporary providers from outside the region, working out of mobile clinics early in disaster recovery. As repairs and reconstruction proceed, local services are restored over weeks or years. Throughout recovery, major tasks include identifying high-risk patients relative to the disaster and underlying health conditions, assisting displaced families as they transition through housing locations, and tracking their evolving access to health care and community services as they are restored. Postdisaster sources of financial assistance for the disaster-exposed population are often temporary and evolving, requiring up-to-date information to cover costs of care until stable services and insurance coverage are restored. Evidence to support disaster recovery health care improvement will require research funding and metrics on structures, processes, and outcomes of the disaster recovery medical home and care coordination, based on adaptation of standard validated methods to crisis environments. (Disaster Med Public Health Preparedness. 2015;9:337–343)

Keywords

care coordinationcase managementcommunity disruptiondisaster recoverymedical home
Type
Policy Analysis
Information
Disaster Medicine and Public Health Preparedness , Volume 9 , Issue 4 , August 2015 , pp. 337 - 343
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2015 

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