Hurricane sandy: Impact on emergency department and hospital utilization by older adults in Lower Manhattan, New York (USA)

Hiroshi Gotanda, Joyce Fogel, Gregg Husk, Jeffrey M. Levine, Monte Peterson, Kevin Baumlin, Joseph Habboushe

Research output: Contribution to journalArticlepeer-review

36 Scopus citations

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.

Original languageEnglish
Pages (from-to)496-502
Number of pages7
JournalPrehospital and Disaster Medicine
Volume30
Issue number5
DOIs
StatePublished - 19 Aug 2015

Keywords

  • disaster planning
  • geriatrics
  • public health

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