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SAFEHAVEN: Decision Support for Nursing Home Resident Disaster Evacuations

SAFEHAVEN：疗养院居民灾难疏散的决策支持

基本信息

批准号：
8104553
负责人：
Vincent Mor
金额：
$ 3万
依托单位：
BROWN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-08-01 至 2011-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8104553
关键词：
Acute Administrator Adopted Affect Applied Research Area Attention Behavioral Research Binding Bioterrorism Caring Characteristics Code Communities Country Data Development Disaster Planning Disasters Elderly Elements Emergency Situation Employee Strikes Event Face Failure Fire - disasters Florida Future Goals Guidelines Health Health Services Research Health care facility Healthcare Healthcare Systems Hospitals Hurricane Institute of Medicine (U.S.)Institution Interdisciplinary Study Journals Long-Term Care Nursing Medical Medicare claim Morbidity - disease rate NIH Program Announcements Natural Disasters Nursing Homes Outcome Police Population Posture Predisposition Public Health Readiness Recurrence Reporting Research Infrastructure Research Priority Research Proposals Risk Shapes Shelter facility Source Structure System United States United States National Institutes of Health Vulnerable Populations base design emergency service responder evidence base experience gulf coast improved instrument mortality prevent public health emergency public health relevance research study response therapy design web site

项目摘要

DESCRIPTION (provided by applicant): Strategic Approach to Facilitating Evacuation by Health Assessment of Vulnerable Elderly in Nursing Homes (SAFE HAVEN Study). Since the events of September 11th 2001, billions of federal dollars have been devoted to improving the country's preparedness posture and public health infrastructure. Most of the attention has focused on traditional first responders (i.e. fire, police, EMS) and hospital preparedness and less to preparedness among non-acute healthcare facilities such as nursing homes (NH). Emergency planning for vulnerable populations constitutes a major element of community disaster preparedness and the elderly represent a most vulnerable group. NH residents are especially vulnerable, as they have extensive care needs and therefore, higher disaster-associated risks. However, NHs have not traditionally been incorporated into disaster planning at any level, a deficiency that must be remedied to avert a recurrence of the tragic events that occurred in connection with Hurricanes Katrina and Rita and to prevent similar tragedies when hurricanes are bound to strike. Our proposal is a direct response to NIH Program Announcement 06-454 "Behavioral Research on Disasters and Health". The announcement calls for applied research that can be directly utilized in the development of public health structures and interventions designed to redress the current lack of attention focused on health care institutions that serve the vulnerable elderly. Using Medicare claims, quarterly NH resident assessment data, longitudinal facility files and geo-coded data on each hurricane hitting Florida and the Gulf coast states between 2004 and 2007, we propose to estimate the impact of hurricanes on NH residents' morbidity and mortality. Furthermore, using the distance between the nursing home and the predicted path of the hurricane as an instrument, we will estimate the effect of the decision to evacuate or shelter in place on residents' outcomes. Dissemination of study findings will be designed for major medical and public health journals as well as more applied and practitioner oriented outlets including web sites. We will also convene an advisory group of stakeholders associated with the annual Hurricane Summit to assist us with dissemination of results to maximize the likelihood that both state nursing home regulators as well as emergency response coordination officials are alerted to the results of the study. PUBLIC HEALTH RELEVANCE: Hurricanes have a devastating effect on nursing home residents since they may be adversely affected either by being transferred to another setting or by sheltering in place. Using existing nursing home data from multiple sources, this study seeks to understand the consequences of hurricanes and evacuation decisions, providing the first evidence base to inform the creation of evacuation guidelines.

描述（由申请人提供）：通过对疗养院弱势老年人进行健康评估来促进疏散的战略方法（安全港研究）。自 2001 年 9 月 11 日事件以来，数十亿联邦资金已投入用于改善国家的备灾状况和公共卫生基础设施。大多数注意力都集中在传统的急救人员（即消防、警察、急救人员）和医院的准备工作上，而较少关注疗养院 (NH) 等非急性医疗机构的准备工作。针对弱势群体的应急规划是社区备灾的一个主要内容，而老年人是最脆弱的群体。新罕布什尔州居民尤其脆弱，因为他们有广泛的护理需求，因此与灾害相关的风险也更高。然而，传统上，NH 并未纳入任何级别的灾害规划，这一缺陷必须得到纠正，以避免卡特里娜和丽塔飓风相关的悲剧事件再次发生，并防止飓风即将袭击时发生类似的悲剧。我们的提案是对 NIH 计划公告 06-454“灾害与健康行为研究”的直接回应。该公告呼吁开展可直接用于制定公共卫生结构和干预措施的应用研究，以纠正目前对服务弱势老年人的医疗保健机构缺乏关注的问题。利用医疗保险索赔、新罕布什尔州居民季度评估数据、纵向设施档案以及 2004 年至 2007 年间袭击佛罗里达州和墨西哥湾沿岸各州的每次飓风的地理编码数据，我们建议估计飓风对新罕布什尔州居民发病率和死亡率的影响。此外，利用疗养院与飓风预测路径之间的距离作为工具，我们将估计疏散或就地避难的决定对居民结果的影响。研究结果的传播将针对主要的医学和公共卫生期刊以及更多以应用和从业者为导向的媒体（包括网站）。我们还将召集与年度飓风峰会相关的利益相关者咨询小组，协助我们传播结果，以最大限度地提高州疗养院监管机构和应急响应协调官员了解研究结果的可能性。公共卫生相关性：飓风对疗养院居民具有毁灭性影响，因为他们可能会因转移到其他地方或就地避难而受到不利影响。本研究利用多个来源的现有疗养院数据，旨在了解飓风和疏散决策的后果，为制定疏散指南提供第一个证据基础。