Long-term Effects of Disasters on Health Care Utilization: Hurricane Katrina and Older Individuals with Diabetes

灾害对医疗保健利用的长期影响:卡特里娜飓风与老年糖尿病患者

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Abstract

OBJECTIVE: While the short-term effects of disasters on health care utilization are well documented, less is known regarding potential longer-term effects. This study investigates the effects of Hurricane Katrina on the health care utilization of older individuals with diabetes. METHODS: We examined Medicare claims and enrollment data for the 2002-2004 and 2006-2008 time periods for older individuals with diabetes. Our quasi-experimental design analyzed utilization across 2 treated and 3 control groups. We compared the proportion of individuals who received a screen related to diabetes before and after Katrina in the treated groups to the proportions in the control groups. Our regression analysis employs individual and year fixed effects to control for factors specific to a given individual or to a given year. RESULTS: We found that utilization rates in the 2002-2004 period exhibited roughly parallel trends for the treated and control groups, which provides support for our research design. The 2006-2008 utilization rates were generally lower for the treated groups than they were for the control groups. The differences were especially pronounced for older age cohorts. CONCLUSIONS: Our study suggests that the effects of disasters on health care utilization may persist for years after the event. Recovery efforts may be improved by addressing both short-term and long-term health care interruptions. (Disaster Med Public Health Preparedness. 2019;13:724-731).

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