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Hurricane Sandy: Impact on Emergency Department and Hospital Utilization by Older Adults in Lower Manhattan, New York (USA)

Published online by Cambridge University Press:  15 September 2015

Hiroshi Gotanda ,
Joyce Fogel ,
Gregg Husk ,
Jeffrey M. Levine ,
Monte Peterson ,
Kevin Baumlin  and
Joseph Habboushe
Hiroshi Gotanda*
Affiliation:
Department of Medicine, Mount Sinai Beth Israel, New York, New York USA
Joyce Fogel
Affiliation:
Division of Geriatrics, Department of Medicine, Mount Sinai Beth Israel, New York, New York USA Department Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York USA
Gregg Husk
Affiliation:
Information Technology, Lenox Hill Hospital, New York, New York USA
Jeffrey M. Levine
Affiliation:
Division of Geriatrics, Department of Medicine, Mount Sinai Beth Israel, New York, New York USA Department Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York USA
Monte Peterson
Affiliation:
Division of Geriatrics, Department of Medicine, Mount Sinai Beth Israel, New York, New York USA Department Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York USA
Kevin Baumlin
Affiliation:
Department of Medicine, Mount Sinai Beth Israel, New York, New York USA
Joseph Habboushe
Affiliation:
Department of Medicine, Mount Sinai Beth Israel, New York, New York USA
*
Correspondence: Hiroshi Gotanda, MD Department of Medicine Mount Sinai Beth Israel First Avenue at 16th Street New York, New York 10003 USA E-mail: hgotanda@gmail.com
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Abstract

Background

On October 29th, 2012, Hurricane Sandy caused a storm surge interrupting electricity with disruption to Manhattan’s (New York, USA) health care infrastructure. Beth Israel Medical Center (BIMC) was the only fully functioning major hospital in lower Manhattan during and after Hurricane Sandy. The impact on emergency department (ED) and hospital use by geriatric patients in lower Manhattan was studied.

Methods

The trends of ED visits and hospitalizations in the immediate post-Sandy phase (IPS) during the actual blackout (October 29 through November 4, 2012), and the extended post-Sandy phase (EPS), when neighboring hospitals were still incapacitated (November 5, 2012 through February 10, 2013), were analyzed with baseline. The analysis was broken down by age groups (18-64, 65-79, and 80+ years old) and included the reasons for ED visits and admissions.

Results

During the IPS, there was a significant increase in geriatric visits (from 11% to 16.5% in the 65-79 age group, and from 6.5% to 13% in the 80+ age group) as well as in hospitalizations (from 22.7% to 25.2% in the 65-79 age group, and from 17.6% to 33.8% in the 80+ age group). However, these proportions returned to baseline during the EPS. The proportions of the categories “dialysis,” “respiratory device,” “social,” and “syncope” in geriatric patients in ED visits were significantly higher than younger patients. The increases of the categories “medication,” “dialysis,” “respiratory device,” and “social” represented two-thirds of absolute increase in both ED visits and admissions for the 65-79 age group, and half of the absolute increase in ED visits for the 80+ age group. The categories “social” and “respiratory device” peaked one day after the disaster, “dialysis” peaked two days after, and “medication” peaked three days after in ED visit analysis.

Conclusions

There was a disproportionate increase in ED visits and hospitalizations in the geriatric population compared with the younger population during the IPS. The primary factor of the disproportionate impact on the geriatric population appears to be from indirect effects of the hurricane, mainly due to the subsequent power outages, such as “dialysis,” “respiratory device,” and “social.” Further investigation by chart review may provide more insights to better aid with future disaster preparedness.

GotandaH, FogelJ, HuskG, LevineJM, PetersonM, BaumlinK, HabbousheJ. Hurricane Sandy: Impact on Emergency Department and Hospital Utilization by Older Adults in Lower Manhattan, New York (USA). Prehosp Disaster Med. 2015;30(5):496–502.

Keywords

disaster planninggeriatricspublic health
Type
Brief Reports
Information
Prehospital and Disaster Medicine , Volume 30 , Issue 5 , October 2015 , pp. 496 - 502
Copyright
© World Association for Disaster and Emergency Medicine 2015 

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