A Model for Measuring Ambulatory Access to Care Recovery after Disasters
A Model for Measuring Ambulatory Access to Care Recovery after Disasters
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DOI：
10.3122/jabfm.2018.02.170219
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发表时间：
2018-03-01
影响因子：
2.9
通讯作者：
Dobalian, Aram
中科院分区：
文献类型：
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作者：
Radcliff, Tiffany A.;Chu, Karen;Dobalian, Aram
简介：尽管很少有研究探讨灾害对定期门诊护理服务的影响，但常规护理服务对于应急计划和响应非常重要，因为错过或延迟护理可能会导致更紧急的护理需求。本文提出了门诊护理恢复和复原力的潜在衡量标准，并将这些衡量标准应用于最近发生的灾难的数据。方法：我们将“门诊护理恢复”概念化为完成被取消的预约的中位工作日的变化，将“门诊护理复原力”概念化为灾难之前、期间和之后的时间范围内已完成预约百分比的变化。对退伍军人事务部 (VA) 诊所的预约数据进行了检查，该飓风影响了拥有大量退伍军人人口的沿海地区。结果：对于所研究的灾难，门诊护理的恢复能力与风暴影响的地理位置接近程度有关。在最接近风暴登陆的地区，初级保健恢复时间较长。这项研究表明了常规预约数据在应急计划中的有用性。结论：量化灾难期间的护理中断是评估改善诊所应急准备和响应的干预措施的重要一步。措施的说明性示例捕获了与门诊护理预约相关的灾难事件持续时间和严重程度。
Introduction: Although little research has examined impacts of disasters on scheduled ambulatory care services, routine care delivery is important for emergency planning and response because missed or delayed care can lead to more urgent care needs. This article presents potential measures of ambulatory care recovery and resilience and applies the measures to data around a recent disaster.Methods: We conceptualize "ambulatory care recovery" as the change in median business days to complete appointments that were canceled, and "ambulatory care resiliency" as the change in percentage of completed appointments in time frames before, during, and after disasters. Appointments data from Veterans Affairs (VA) clinics were examined around a category 4 hurricane that affected a coastal area with a substantial veteran population.Results: For the disaster studied, ambulatory care resilience was associated with geographic proximity to the storm's impact. Primary care recovery was longer in locations closest to storm landfall. This research indicates the usefulness of routine appointments data in emergency planning.Conclusion: Quantifying care disruptions around disasters is an important step in assessing interventions to improve emergency preparedness and response for clinics. The illustrative example of measures captured the disaster event duration and severity in relation to ambulatory care appointments.