Providing Healthcare to Evacuees in the Wake of a Natural Disaster: Opportunities to Improve Disaster Planning

Bailey, Jessica H.; deShazo, Richard D.

doi:10.1097/maj.0b013e318180f19f

Cited by 15 publications

(16 citation statements)

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“…In a post-disaster situation where infrastructure collapse affects the essential conditions for maintaining elderly peoples' health[25], [26], evacuation may be essential regardless of the environmental risks posed by radiation exposure. However, the findings of this study indicate that evacuation may not be the best life-saving strategy.…”

Section: Discussionmentioning

confidence: 99%

Mortality Risk amongst Nursing Home Residents Evacuated after the Fukushima Nuclear Accident: A Retrospective Cohort Study

Nomura

Gilmour²,

Tsubokura³

et al. 2013

PLoS ONE

102

103

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BackgroundSafety of evacuation is of paramount importance in disaster planning for elderly people; however, little effort has been made to investigate evacuation-related mortality risks. After the Fukushima Daiichi Nuclear Plant accident we conducted a retrospective cohort survival survey of elderly evacuees.MethodsA total of 715 residents admitted to five nursing homes in Minamisoma city, Fukushima Prefecture in the five years before 11th March 2011 joined this retrospective cohort study. Demographic and clinical characteristics were drawn from facility medical records. Evacuation histories were tracked until the end of 2011. The evacuation's impact on mortality was assessed using mortality incidence density and hazard ratios in Cox proportional hazards regression.ResultsOverall relative mortality risk before and after the earthquake was 2.68 (95% CI: 2.04–3.49). There was a substantial variation in mortality risks across the facilities ranging from 0.77 (95% CI: 0.34–1.76) to 2.88 (95% CI: 1.74–4.76). No meaningful influence of evacuation distance on mortality was observed although the first evacuation from the original facility caused significantly higher mortality than subsequent evacuations, with a hazard ratio of 1.94 (95% CI: 1.07–3.49).ConclusionHigh mortality, due to initial evacuation, suggests that evacuation of the elderly was not the best life-saving strategy for the Fukushima nuclear disaster. Careful consideration of the relative risks of radiation exposure and the risks and benefits of evacuation is essential. Facility-specific disaster response strategies, including in-site relief and care, may have a strong influence on survival. Where evacuation is necessary, careful planning and coordination with other nursing homes, evacuation sites and government disaster agencies is essential to reduce the risk of mortality.

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Section: Discussionmentioning

confidence: 99%

Mortality Risk amongst Nursing Home Residents Evacuated after the Fukushima Nuclear Accident: A Retrospective Cohort Study

Nomura

Gilmour²,

Tsubokura³

et al. 2013

PLoS ONE

102

103

View full text Add to dashboard Cite

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“…64-66 Recent lessons learned from Hurricane Katrina and Haiti revealed that retrospective and prospective assessment of existing health disparities is fundamental for exhaustive disaster preparedness and response planning. 6,14,67-69 …”

Section: Introductionmentioning

confidence: 99%

Secondary Surge Capacity: A Framework for Understanding Long-Term Access to Primary Care for Medically Vulnerable Populations in Disaster Recovery

et al. 2012

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Disasters create a secondary surge in casualties due to the sudden increase in need for long-term healthcare within the disaster population. Surging demands for medical care in the months after a disaster place excess strain on an overtaxed health care system operating at maximum or reduced capacity. Amplified demand met by diminishing supply likely disrupts the provision of and access to routine health services in the months post-disaster. Health disparities within vulnerable disaster populations present before the disaster are often exacerbated by systematic differences in access to primary care after the disaster. The following article applies a leading health services use model to identify areas of vulnerability that perpetuate health disparities for at-risk populations seeking entry into a frayed health system recovering from a disaster. We propose a framework to understand the role of the medical system in modifying the health impact of the secondary surge on vulnerable populations. Baseline assessment of existing needs and the anticipation of ballooning chronic health care needs following the acute response for at-risk populations are vulnerability gaps currently overlooked in national surge capacity plans.

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“…For example, during Hurricane Katrina in Jackson, Mississippi, the evacuees streamed to shelters. The shelters had prepared for a large number of trauma cases and were poorly prepared to provide any medical treatment other than first aid (Bailey & Deshazo 2008). Care for evacuees with chronic diseases was delayed while ad hoc arrangements for delivery of health care, medication dispensing and medical records were being established (Bailey & Deshazo 2008).…”

Section: Resultsmentioning

confidence: 99%

“…2007; Arrieta et al. 2008; Bailey & Deshazo 2008), there is a need to collect information on effective strategies for support.…”

Section: Introductionmentioning

confidence: 99%

“…This disruption in health management could result in fatal consequences (Ford et al 2006, Hurricane Katrina Community Advisory Group & Kessler, 2007Miller & Arquilla 2008). Although several researchers have documented the hardships faced by people with chronic diseases during natural disasters (Brodie et al 2006, Hurricane Katrina Community Advisory Group & Kessler 2007, Mori et al 2007Aldrich & Benson 2008, Bailey & Deshazo 2008Greenough et al 2008, Miller & Arquilla 2008, and inadequate preparation of public health agencies and shelters to handle individuals with chronic diseases has been reported (Millin et al 2006;Guha-Sapir et al 2007, Hurricane Katrina Community Advisory Group & Kessler, 2007Krol et al 2007;Arrieta et al 2008;Bailey & Deshazo 2008), there is a need to collect information on effective strategies for support.…”

Section: Introductionmentioning

confidence: 99%

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Synthesis of literature on strategies for chronic disease management post disasters

Radhakrishnan¹,

Jacelon²

2009

J of Nursing and Healthcare

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Synthesis of literature on strategies for chronic disease management post disasters Aims. Disasters are devastating events that can overwhelm individuals with chronic diseases and shift their priorities from routine disease management to immediate survival needs. There were fatal consequences to this shift in health management during recent disasters. The following review of literature was conducted to identify strategies to help manage chronic illness during disasters. Background. During several recent disasters many people with pre-existing chronic diseases sought help at disaster shelters. These individuals experienced hardships due to difficulty contacting physicians, lack of medications, insufficient insurance coverage, lack of transportation, and inadequate resources in shelters. Method. The Ecological Model of Disaster Management guided the selection and synthesis of research articles focused on the management of adults with chronic diseases during disasters. Articles published between January 2000-May 2009 were included. Research focused on mental illness, children or adolescents was excluded. Findings. The sample included five surveys, five retrospective record audit, four qualitative studies and one study with correlational study design. The review yielded recommendations for disaster planning for individuals with chronic diseases. Conclusions. Integration of beneficial strategies, informed by the literature and tailored to characteristics of the chronic disease population can provide effective solutions for chronic disease management post disaster. Technology's role in facilitating chronic disease management during disasters is discussed. Relevance to clinical practice. Being the most plentiful health care providers and adept at working with individuals with chronic disease, nurses are in an excellent position to take leading roles in disaster planning missions. Educating individuals on self-management techniques, participating in drills, and familiarising themselves with disaster technology are some of the ways nurses can help and support individuals with chronic diseases during disasters.

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Providing Healthcare to Evacuees in the Wake of a Natural Disaster: Opportunities to Improve Disaster Planning

Cited by 15 publications

References 1 publication

Mortality Risk amongst Nursing Home Residents Evacuated after the Fukushima Nuclear Accident: A Retrospective Cohort Study

Mortality Risk amongst Nursing Home Residents Evacuated after the Fukushima Nuclear Accident: A Retrospective Cohort Study

Secondary Surge Capacity: A Framework for Understanding Long-Term Access to Primary Care for Medically Vulnerable Populations in Disaster Recovery

Synthesis of literature on strategies for chronic disease management post disasters

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