Impact of Nepal Earthquake on Patients Presenting for Emergency Care at Patan Hospital

Tembe, Mimang; Dhakal, Sushma; Shrestha, Ashis; Mugele, Josh; House, Darlene R.

doi:10.1017/dmp.2018.20

Cited by 7 publications

(7 citation statements)

References 17 publications

(38 reference statements)

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“…Respondents with psychiatric illnesses did not show an increase in alcohol intake as compared to healthy control groups. This observation is different from the previous study, which reported the increase in alcohol intoxication and abuse after natural disasters (e.g., earthquake) (Tembe et al, 2019). As the government implemented outing restriction during the COVID-19 epidemic for all citizens, people with and without psychiatric illnesses did not have frequent access to purchase alcohol from local supermarkets.…”

Section: Discussioncontrasting

confidence: 84%

Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsychiatry

Hao

Tan

Jiang

et al. 2020

Brain, Behavior, and Immunity

886

841

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Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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Section: Discussioncontrasting

confidence: 84%

Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsychiatry

Hao

Tan

Jiang

et al. 2020

Brain, Behavior, and Immunity

886

841

View full text Add to dashboard Cite

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“…One explanation is the fact that respiratory conditions sustained would not require hospitalization, and would rather be reflected in outpatient care. Indeed, a study in a hospital near Kathmandu found an increase in emergency department visits due to respiratory diseases [ 37 ]. Such an explanation is not plausible for pregnancy-related admissions, and it may indicate that pregnant women are not receiving skilled care and deliveries are not conducted in health facilities.…”

Section: Resultsmentioning

confidence: 99%

“Recovering, not recovered” Hospital disaster resilience: a case-study from the 2015 earthquake in Nepal

Almeida

2022

Global Health Action

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Background Disasters are an increasing threat to human health, but we know little about their impact on health services, particularly in low and middle-income settings. ‘Resilient hospitals’ have been increasingly recognized as a cornerstone of disaster management. While various frameworks of hospital resilience exist, they emerged from pre-disaster considerations, and do not incorporate evidence from post-disaster settings. Objective This dissertation investigated the impact of a large-scale sudden onset disaster in a tertiary hospital in Nepal, and explored its resilience mechanisms. Methodology This consists of an in-depth case-study combining quantitative data from routinely generated hospital records and qualitative data from semi-structured interviews with hospital staff. We used both advanced statistical methods and mixed inductive and deductive coding to analyze the data. Results Most of the admitted earthquake victims required surgical interventions and long hospitalizations, considerably straining the hospital. For six weeks, the average number of daily admissions decreased. During this period, the share of injury-related admissions was particularly high, and such admissions were particularly long compared to the baseline. Admissions due to other conditions relatively decreased and were shorter. We found that the hospital’s resilience was highly dependent on emerging adaptations, in addition to the pre-existing disaster plan. Individual resilience of staff also played a major role, and was influenced by senses of safety, meaningfulness, and belonging. Conclusion Hospitals should prepare resources and plan for their known disaster risks, but should also allow for a certain flexibility to innovative adaptions to emerging, unforeseen challenges. Challenges faced by hospital workers should not be undermined, and addressing them will increase hospital resilience.

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“…As such, most respiratory consequences of the 2015 earthquake would be reflected in outpatient care. A study in Patan Hospital, in the vicinity of Kathmandu, showed that there were significantly more emergency visits due to cardiovascular, psychiatric, respiratory, and hematologic conditions in the four months after the earthquake, compared to the same period one year before 19 .…”

Section: Discussionmentioning

confidence: 99%

Changes in patient admissions after the 2015 Earthquake: a tertiary hospital-based study in Kathmandu, Nepal

Almeida

Schlüter

Loenhout

et al. 2020

Sci Rep

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Literature on earthquake impact on hospital admissions is lacking, particularly in low-resource settings. Our aim was to study the pattern of admissions before and after the 2015 earthquake in a tertiary hospital in Nepal. We used routine hospital data from 9,596 admissions, and defined four periods: pre-earthquake (pre-EQ), acute (EQ1), post-acute (EQ2), and post-earthquake (post-EQ). We compared length of hospital stay (LOS) across the study periods using negative binomial regressions. We used logistic regressions to study changes in probability of admission for diagnostic categories, and Generalized Additive Models to model the difference in number of admissions compared to pre-EQ baseline. LOS was longer in EQ1 than during pre-EQ, in particular for injury-related admissions. In EQ1, the odds of injury admissions increased, while they decreased for the majority of other diagnoses, with the odds of pregnancy-related admissions remaining low until post-EQ. The number of admissions dropped in EQ1 and EQ2, and returned to pre-EQ trends in post-EQ, accumulating 381 admissions lost (CI: 206-556). Our findings suggest that hospital disaster plans must not only foresee injury management after earthquakes, but also ensure accessibility, in particular for pregnant women, and promote a quick return to normality to prevent additional negative health outcomes. Violent, sudden-onset disasters, such as hurricanes or earthquakes, cause considerable damage in communities, leading to widespread destruction 1. While deaths and direct injuries are immediate and expectable consequences of such disasters, drastic changes in the surrounding environment may have longer-term health effects 2-7. These disasters also heavily disturb health systems, which must provide healthcare in a context of sudden increase of health needs, radical change of priority conditions, infrastructural and material damage, and staff shortages 8. While most of the victims in need of care during and after a disaster are managed in an outpatient basis at emergency departments, a considerable amount of people will require hospitalization 9. However, there is inconsistent evidence on the impact on hospital admissions immediately after and in the months following violent, sudden-onset disasters 3,10-12. Earthquakes are the most destructive type of natural disaster, having killed nearly 720,000 people globally between 2000 and 2018. About two thirds of all events worldwide occurred in Asia, where earthquakes affect much more people than earthquakes in all the other continents 13. Rapid population growth, urbanization, poverty, and geological risks contribute to Asia's seismic vulnerability. Nepal is located on the boundaries of two colliding tectonic plates. On April 25 th 2015, an earthquake with a moment magnitude of 7.8 severely hit the country. The epicenter was in Gorkha district, and heavy infrastructural damage occurred in neighbouring regions, including in the capital city of Kathmandu located 76 km away. There were several aftershocks, the strongest occurri...

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Impact of Nepal Earthquake on Patients Presenting for Emergency Care at Patan Hospital

Abstract: Understanding emergency department utilization after the earthquake has the potential to give further insight into improving disaster preparedness plans for post-disaster health needs. (Disaster Med Public Health Preparedness. 2018;page 1 of 6).

Cited by 7 publications

References 17 publications

Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsychiatry

Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsychiatry

“Recovering, not recovered” Hospital disaster resilience: a case-study from the 2015 earthquake in Nepal

Changes in patient admissions after the 2015 Earthquake: a tertiary hospital-based study in Kathmandu, Nepal

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