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Comparing Primary Health-Care Service Delivery Disruptions Across Disasters

Published online by Cambridge University Press:  17 August 2021

Tiffany A. Radcliff Open the ORCID record for Tiffany A. Radcliff [Opens in a new window] ,
Karen Chu ,
Claudia Der-Martirosian  and
Aram Dobalian
Tiffany A. Radcliff*
Affiliation:
Veterans Emergency Management Evaluation Center (VEMEC), U.S. Department of Veterans Affairs, North Hills, California, USA Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, Texas, USA
Karen Chu
Affiliation:
Veterans Emergency Management Evaluation Center (VEMEC), U.S. Department of Veterans Affairs, North Hills, California, USA
Claudia Der-Martirosian
Affiliation:
Veterans Emergency Management Evaluation Center (VEMEC), U.S. Department of Veterans Affairs, North Hills, California, USA
Aram Dobalian
Affiliation:
Veterans Emergency Management Evaluation Center (VEMEC), U.S. Department of Veterans Affairs, North Hills, California, USA Division of Health Systems Management and Policy, School of Public Health, University of Memphis, Memphis, Tennessee, USA
*
Corresponding author: Tiffany A. Radcliff, Email: tiffany.radcliff@tamu.edu
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Abstract

Objective:

The aim of this study was to compare primary care appointment disruptions around Hurricanes Ike (2008) and Harvey (2017) and identify patterns that indicate differing continuity of primary care or care systems across events.

Methods:

Primary care appointment records covering 5 wk before and after each storm were identified for Veterans Health Affairs (VA) facilities in the greater Houston and surrounding areas and a comparison group of VA facilities located elsewhere. Appointment disposition percentages were compared within and across storm events to assess care disruptions.

Results:

For Hurricane Harvey, 14% of primary care appointments were completed during the week of landfall (vs 33% for Hurricane Ike and 69% in comparison clinics), and 49% were completed the following week (vs 58% for Hurricane Ike and 71% for comparison clinics). By the second week after Hurricane Ike and third week after Harvey, the scheduled appointment completion percentage returned to prestorm levels of approximately 60%.

Conclusions:

There were greater and more persistent care disruptions for Hurricane Harvey relative to Hurricane Ike. As catastrophic emergencies including major natural disasters and infectious disease pandemics become a more recognized threat to primary and preventive care delivery, health-care systems should consider implementing strategies to monitor and ensure primary care appointment continuity.

Keywords

ambulatory caredisastersveteranshurricanesdisruptions
Type
Brief Report
Information
Disaster Medicine and Public Health Preparedness , Volume 16 , Issue 5 , October 2022 , pp. 1802 - 1805
Copyright
© Society for Disaster Medicine and Public Health, Inc. 2021

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References

Lewis, C, Seervai, S, Shah, T. Primary Care and the COVID-19 Pandemic. To the Point (blog). Washington, DC: The Commonwealth Fund. doi: 10.26099/73K0-A831CrossRefGoogle Scholar
Weinstein, E, Ragazzoni, L, Burkle, F, et al. Delayed primary and specialty care - the COVID-19 pandemic second wave. Disaster Med Public Health Prep. 2020;14(3):e19-e21. doi: 10.1017/dmp.2020.148 CrossRefGoogle Scholar
UNISDR (United Nations International Strategy for Disaster Reduction). Technical guidance for monitoring and reporting on progress in achieving the global targets of the Sendai Framework for Disaster Risk Reduction. Published 2017. https://www.preventionweb.net/files/54970_techguidancefdigitalhr.pdf. Accessed April 29, 2021.Google Scholar
US Census Bureau. Two Texas metropolitan areas gain more than 1 million people. America Counts: Stories behind the numbers. Published 2019. https://www.census.gov/library/stories/2019/04/two-texas-metropolitan-areas-gain-one-million-people.html. Accessed May 8, 2020.Google Scholar
NOAA. Billion-dollar weather and climate disasters: events. National Centers for Environmental Information (NCEI). https://www.ncdc.noaa.gov/billions/events. Accessed May 8, 2020.Google Scholar
Karaye, I, Stone, KW, Casillas, GA, et al. A spatial analysis of possible environmental exposures in recreational areas impacted by Hurricane Harvey flooding, Harris County, Texas. Environ Manage. 2019;64(4):381-390. doi: 10.1007/s00267-019-01204-4 Google ScholarPubMed
Radcliff, TA, Chu, K, Der-Martirosian, C, et al. A model for measuring ambulatory access to care recovery after disasters. J Am Board Fam Med. 2018;31(2):252-259. doi: 10.3122/jabfm.2018.02.170219 CrossRefGoogle Scholar
Price, M, Davidson, TM, Andrews, JO, et al. Access, use and completion of a brief disaster mental health intervention among Hispanics, African-Americans and Whites affected by Hurricane Ike. J Telemed Telecare. 2013;19(2):70-74. doi: 10.1177/1357633X13476230 CrossRefGoogle ScholarPubMed
Lowe, SR, Norris, FH, Galea, S. Mental health service utilization among natural disaster survivors with perceived need for services. Psychiatr Serv. 2016;67(3):354-357. doi: 10.1176/appi.ps.201500027 CrossRefGoogle ScholarPubMed
Gaston, SA, Galea, S, Cohen, GH, et al. Potential impact of 2020 US decennial census data collection on disaster preparedness and population mental health. Am J Public Health. 2019;109(8):1079-1083. doi: 10.2105/AJPH.2019.305150 Google ScholarPubMed
Der-Martirosian, C, Griffin, AR, Chu, K, et al. Telehealth at the US Department of Veterans Affairs after Hurricane Sandy. J Telemed Telecare. 2019;25(5):310-317. doi: 10.1177/1357633X17751005 Google ScholarPubMed