Emergency Department Use Among Assisted Living Residents After Hurricane Irma.
Emergency Department Use Among Assisted Living Residents After Hurricane Irma.
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DOI：
10.1016/j.jamda.2020.10.010
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发表时间：
2021-04
影响因子：
7.6
通讯作者：
Dosa DM
中科院分区：
文献类型：
--
作者：
Hua CL;Thomas KS;Peterson LJ;Hyer K;Dosa DM
养老院的居民特别容易受到飓风后的不利影响。先前的研究表明，自然灾害发生后，社区老年人的急诊（艾德）就诊率增加。然而，很少有人知道飓风对居住在辅助生活（AL）设置的老年人的大量人口的影响，特别是风暴对艾德访问率和原因的影响。我们检查了佛罗里达的AL居民在2017年飓风伊尔玛之后因受伤和其他医疗原因使用艾德的比率是否增加。回顾性队列研究2016年30，358名医疗保险按服务收费受益人和2017年居住在佛罗里达AL社区的28，922名受益人的样本。2016年和2017年9月1日30天和90天内每1,000人日的伤害相关和其他医疗就诊次数。我们使用AL固定效应的线性回归调整了年龄、种族、性别和慢性疾病。我们比较了2016年至2017年导致艾德就诊的前10位主要诊断。调整后的损伤相关就诊率在30天时高出13%，但在90天时没有差异。2017年30天内的其他医疗访问量比2016年高出14%，90天内高出9%。与2016年不同，心力衰竭是2017年9月1日90天内艾德就诊的主要原因。鉴于飓风后艾德访问的可能性增加，应在备灾和应对工作中更加关注AL社区。我们检查了飓风厄玛后佛罗里达辅助生活居民的急诊室使用风险调整率，并描述了就诊类型。我们的研究记录了利用率的显著提高。
Nursing home residents are especially vulnerable to adverse outcomes after a hurricane. Prior research suggests that emergency department (ED) visits increase among community residing older adults after natural disasters. However, little is known about the impact of hurricanes on the large population of older adults residing in assisted living (AL) settings, particularly the influence of storms on the rates and causes of ED visits. We examined whether rates of ED use for injuries and other medical reasons increased after Hurricane Irma in 2017 among AL residents in Florida. Retrospective cohort study Samples of 30,358 Medicare fee-for-service beneficiaries in 2016 and 28,922 beneficiaries in 2017 who resided in Florida AL communities. The number injury-related and other medical visits per 1,000 person-days within 30 and 90 days of September 1st in 2016 and 2017. We adjusted for age, race, sex, and chronic conditions using linear regression with AL fixed effects. We compared the top 10 primary diagnoses resulting in an ED visit between 2016 and 2017. Adjusted rates of injury-related visits were 13% higher at 30 days but did not differ at 90 days. Other medical visits were 14% higher at 30 days in 2017 than in 2016 and 9% higher at 90 days. Heart failure was a leading cause of ED visits within 90 days of September 1st in 2017, unlike in 2016. Increased attention should be paid to AL communities in disaster preparedness and response efforts given the increased likelihood of ED visits following a hurricane. We examined risk-adjusted rates of emergency department use among Florida assisted living residents after Hurricane Irma and described types of visits. Our study documented significant increases in utilization rates.
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