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Hospitalization Rates Among Dialysis Patients During Hurricane Katrina

Published online by Cambridge University Press:  19 July 2012

David Howard*
Affiliation:
Department of Health Policy and Management, Department of Economics, Emory University, Atlanta, Georgia USA
Rebecca Zhang
Affiliation:
Department of Biostatistics, Emory University, Atlanta, Georgia USA
Yijian Huang
Affiliation:
Department of Biostatistics, Emory University, Atlanta, Georgia USA
Nancy Kutner
Affiliation:
Department of Rehabilitation Medicine, Department of Sociology, Emory University, Atlanta, Georgia USA
*
Correspondence: David Howard, PhD Department of Health Policy and Management Emory University 1518 Clifton Road NE Atlanta, GA 30322 USA E-mail david.howard@emory.edu

Abstract

Introduction

Dialysis centers struggled to maintain continuity of care for dialysis patients during and immediately following Hurricane Katrina's landfall on the US Gulf Coast in August 2005. However, the impact on patient health and service use is unclear.

Problem

The impact of Hurricane Katrina on hospitalization rates among dialysis patients was estimated.

Methods

Data from the United States Renal Data System were used to identify patients receiving dialysis from January 1, 2001 through August 29, 2005 at clinics that experienced service disruptions during Hurricane Katrina. A repeated events duration model was used with a time-varying Hurricane Katrina indicator to estimate trends in hospitalization rates. Trends were estimated separately by cause: surgical hospitalizations, medical, non-renal-related hospitalizations, and renal-related hospitalizations.

Results

The rate ratio for all-cause hospitalization associated with the time-varying Hurricane Katrina indicator was 1.16 (95% CI, 1.05-1.29; P = .004). The ratios for cause-specific hospitalization were: surgery, 0.84 (95% CI, 0.68-1.04; P = .11); renal-related admissions, 2.53 (95% CI, 2.09-3.06); P < .001), and medical non-renal related, 1.04 (95% CI, 0.89-1.20; P = .63). The estimated number of excess renal-related hospital admissions attributable to Katrina was 140, representing approximately three percent of dialysis patients at the affected clinics.

Conclusions

Hospitalization rates among dialysis patients increased in the month following the Hurricane Katrina landfall, suggesting that providers and patients were not adequately prepared for large-scale disasters.

Howard D, Zhang R, Huang Y, Kutner N. Hospitalization rates among dialysis patients during Hurricane Katrina. Prehosp Disaster Med. 2012;27(4):1-5.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2012

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