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Temporal and Spatial Patterns in Utilization of Mental Health Services During and After Hurricane Sandy: Emergency Department and Inpatient Hospitalizations in New York City

  • Fangtao Tony He (a1), Nneka Lundy De La Cruz (a1), Donald Olson (a1), Sungwoo Lim (a1), Amber Levanon Seligson (a1), Gerod Hall (a1), Jillian Jessup (a1) and Charon Gwynn (a1)...

Abstract

Objective

Hurricane Sandy made landfall on October 29, 2012, causing a coastal storm surge and extensive flooding, which led to the closure of several health care facilities in New York City (NYC) and prolonged interruptions in service delivery. The impact on mental health–related emergency department (ED) and inpatient hospital service utilization was studied.

Methods

Data came from the New York Statewide Planning and Research Cooperative System. We obtained mental health–related data among NYC residents from 2010 to 2013. Patients were grouped into 5 geographic areas, including service areas of closed hospitals, the Hurricane Sandy evaluation zone, and all of NYC. The Farrington method was used to detect increases in ED visits and hospitalizations for the post-Sandy period.

Results

Open hospitals experienced a substantial increase in psychiatric ED visits from patients living in the service areas of closed hospitals. This surge in psychiatric ED visits persisted for 4 to 6 months after Hurricane Sandy. However, the increase in psychiatric hospitalizations was observed for 1 to 3 months.

Conclusions

Several NYC hospitals received a substantially larger number of ED patients from service areas of closed hospitals after Hurricane Sandy, unlike other hospitals that experienced a decrease. Because of potential surges in the number of psychiatric ED visits, resource allocation to hospitals should be considered. (Disaster Med Public Health Preparedness. 2016;10:512–517)

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Copyright

Corresponding author

Correspondence and reprint requests to Fangtao He, MS, Division of Epidemiology, New York City Department of Health and Mental Hygiene, 42-09 28th Street, Long Island City, NY 11101-4132 (e-mail: fhe1@health.nyc.gov).

References

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1. Gibbs, LI, Holloway, CF. Hurricane Sandy After Action: Report and Recommendations to Mayor Michael R. Bloomberg. New York: New York City Mayor’s Office; 2013. http://www.nyc.gov/html/recovery/downloads/pdf/sandy_aar_5.2.13.pdf. Accessed November 3, 2015.
2. Howland, RE, Li, W, Madsen, AM, et al. Evaluating the use of an electronic death registration system for mortality surveillance during and after Hurricane Sandy: New York City, 2012. Am J Public Health. 2015;105(11):e55-e62.
3. Centers for Disease Control and Prevention. Notes from the field: carbon monoxide exposures reported to poison centers and related to hurricane Sandy—Northeastern United States, 2012. MMWR Morb Mortal Wkly Rep. 2012;61(44):905.
4. Tofighi, B, Grossman, E, Williams, AR, et al. Outcomes among buprenorphine-naloxone primary care patients after Hurricane Sandy. Addict Sci Clin Pract. 2014;9:3. doi: 10.1186/1940-0640-9-3.
5. Runkle, JD, Brock-Martin, A, Karmaus, W, Svendsen, ER. Secondary surge capacity: a framework for understanding long-term access to primary care for medically vulnerable populations in disaster recovery. Am J Public Health. 2012;102(12):e24-e32.
6. Sebek, K, Jacobson, L, Wang, J, et al. Assessing capacity and disease burden in a virtual network of New York City primary care providers following Hurricane Sandy. J Urban Health. 2014;91(4):615-622.
7. Lowe, SR, Sampson, L, Gruebner, O, Galea, S. Mental health service need and use in the aftermath of Hurricane Sandy: findings in a population-based sample of New York City residents. Community Ment Health J. 2016;52(1):25-31. http://dx.doi.org/10.1007/s10597-015-9947-4.
8. Lurie, N, Manolio, T, Patterson, AP, et al. Research as part of public health emergency response. N Engl J Med. 2013;368(13):1251-1255.
9. New York City Emergency Management, Hurricane Evacuation Zone 1 http://www1.nyc.gov/site/em/ready/hurricane-evacuation.page. Accessed January 2016.
10. Farrington, CP, Andrews, NJ, Beale, AD, Catchpole, MA. A statistical algorithm for the early detection of outbreaks of infectious disease. J R Stat Soc Ser A Stat Soc . 1996;159(3):547-563.
11. Höhle, M. Surveillance: an R package for the monitoring of infectious diseases. Comput Stat. 2007;22(4):571-582.
12. Lee, DC, Smith, SW, Carr, BG, et al. Redistribution of emergency department patients after disaster-related closures of a public versus private hospital in New York City. Disaster Med Public Health Prep. 2015;9(3):256-264.
13. Adalja, AA, Wastson, M, Bouri, N, et al. Absorbing citywide patient surge during Hurricane Sandy: a case study in accommodating multiple hospital evacuations. Ann Emerg Med. 2014;64(1):66-73.

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Appendix B

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Temporal and Spatial Patterns in Utilization of Mental Health Services During and After Hurricane Sandy: Emergency Department and Inpatient Hospitalizations in New York City

  • Fangtao Tony He (a1), Nneka Lundy De La Cruz (a1), Donald Olson (a1), Sungwoo Lim (a1), Amber Levanon Seligson (a1), Gerod Hall (a1), Jillian Jessup (a1) and Charon Gwynn (a1)...

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