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All-Cause Hospitalizations after Large-Scale Hurricanes among Older Adults: A Self-Controlled Case Series Study

Published online by Cambridge University Press:  17 November 2020

Sue Anne Bell Open the ORCID record for Sue Anne Bell [Opens in a new window] ,
Theodore J. Iwashyna ,
Xingyu Zhang ,
Bingxin Chen  and
Matthew A. Davis
Sue Anne Bell*
Affiliation:
Department of Systems, Populations, and Leadership, University of Michigan School of Nursing, Ann Arbor, Michigan USA Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan USA
Theodore J. Iwashyna
Affiliation:
Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan USA University of Michigan Medical School, Department of Internal Medicine, Ann Arbor, Michigan USA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan USA
Xingyu Zhang
Affiliation:
Department of Systems, Populations, and Leadership, University of Michigan School of Nursing, Ann Arbor, Michigan USA
Bingxin Chen
Affiliation:
Department of Systems, Populations, and Leadership, University of Michigan School of Nursing, Ann Arbor, Michigan USA
Matthew A. Davis
Affiliation:
Department of Systems, Populations, and Leadership, University of Michigan School of Nursing, Ann Arbor, Michigan USA Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan USA Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan USA
*
Correspondence: Sue Anne Bell, PhD, FNP-BC, Assistant Professor, University of Michigan, 400 North Ingalls Building, Ann Arbor, Michigan 48109 USA, E-mail: sabell@umich.edu
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Abstract

Introduction:

Understanding the drivers of health care utilization patterns following disasters can better support health planning. This study characterized all-cause hospitalizations among older Americans after eight large-scale hurricanes.

Study Objective:

The objective of this study was to characterize all-cause hospitalizations for any cause among older Americans in the 30 days after eight large-scale hurricanes.

Methods:

A self-controlled case series study among Medicare beneficiaries (age 65+) exposed to one of eight hurricanes was conducted. The predicted probability of sociodemographic factors associated with hospitalization using logit models was estimated.

Results:

Hurricane Sandy (2012) had the highest post-hurricane admission rate, a 23% increase (incidence rate ratio [IRR] = 1.23; 95% CI, 1.22-1.24), while Hurricane Irene in 2011 had only a 10% increase (IRR = 1.10; 95% CI, 1.09-1.11). Higher likelihood of hospitalization occurring after hurricanes included being 85 or older (36.8% probability of hospitalization; 95% CI, 34.7-39.0) and being dually eligible for Medicare and Medicaid (62.8%; 95% CI, 60.7-64.9).

Conclusion:

Planning to address the surge in hospitalization for a longer time period after hurricanes and interventions targeted to support aging Americans are needed.

Keywords

delivery of health caredisasterdisaster preparednessolder adults
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 1 , February 2021 , pp. 25 - 31
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Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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