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Hospital Admissions Elevated for Weeks After Natural Disasters

Hospitals in the areas affected by the devastating hurricane Harvey will likely be full even longer than they expect during the disaster’s aftermath.

That assumption is based on a new study, published in Annals of Emergency Medicine, which found that older adults might have higher rates of hospital admissions for weeks after a national disaster.

Based on the calamity in the study, which occurred over a much shorter period and affected many fewer people than Hurricane Harvey, University of Michigan School of Nursing researchers and colleagues predicted three days of anticipated injuries and health issues.

The study found that in the 30 days after a tornado outbreak in the Southeast and Midwest in 2011, hospital admissions for adults 65 and older rose an average of 4% in affected ZIP codes in Alabama, Mississippi, Georgia, and Tennessee.

While admissions didn’t increase significantly in the other three states when the researchers look specifically at that level, both hospitalizations and intensive care admissions rose 9% in Alabama, which suffered the most tornadoes.

That was even the case when the three days following the disaster were excluded from the admissions data. Results indicated that hospitalizations for any cause remained higher than when compared with the other 11 months of the year, for an incidence rate ratio of 1.04. No increases were documented in overall ICU admissions or in hospital mortality associated with the natural disaster.

"It was obvious that these discrete severe events would cause trauma on the day or so after tornado touchdown," said principal investigator Sue Anne Bell, PhD, MSN, clinical associate professor at the University of Michigan School of Nursing. "It was not obvious, and had never been previously shown, that they caused hundreds of extra admissions in the weeks after the tornado."

Researchers analyzed Medicare claims for about 27,000 patients and 57,000 hospitalizations after the tornado outbreak in April 2011 — considered one of the largest tornado-related natural disasters in United States history. During the weather event, 11 tornadoes hit swathes of Alabama, while four tornadoes touched down in Georgia and Tennessee, and three in Mississippi.

On average, the article notes, 5,028 hospital admissions in those ZIP codes occurred during the 30 days after, compared to 4,712 hospitalizations per 30 days the rest of the year.

Bell suggests the study results could have plans for response, recovery, and hospital staffing after an emergency. While federal guidelines require availability of 20% of all staffed beds within four hours after a disaster, she questioned whether surge-planning models consider longer time frames.

"The cost that hospitals incur and the effect on the community and manpower really lasts a lot longer than expected," she said. "Hospitals and communities need to be considering this."

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