Redistribution of Emergency Department Patients After Disaster-Related Closures of a Public Versus Private Hospital in New York City

Abstract

Sudden hospital closures displace patients from usual sources of care and force them to access facilities that lack their prior medical records. For patients with complex needs and for nearby hospitals already strained by high volume, disaster-related hospital closures induce a public health emergency. Our objective was to analyze responses of patients from public versus private emergency departments after closure of their usual hospital after Hurricane Sandy. Using a statewide database of emergency visits, we followed patients with an established pattern of accessing 1 of 2 hospitals that closed after Hurricane Sandy: Bellevue Hospital Center and NYU Langone Medical Center. We determined how these patients redistributed for emergency care after the storm. We found that proximity strongly predicted patient redistribution to nearby open hospitals. However, for patients from the closed public hospital, this redistribution was also influenced by hospital ownership, because patients redistributed to other public hospitals at rates higher than expected by proximity alone. This differential response to hospital closures demonstrates significant differences in how public and private patients respond to changes in health care access during disasters. Public health response must consider these differences to meet the needs of all patients affected by disasters and other public health emergencies.

Vulnerability of Older Adults in Disasters: Emergency Department Utilization by Geriatric Patients After Hurricane Sandy

“…45,46 On the other hand, ensuring access to primary care health providers serving vulnerable subgroups can represent resiliency and display adaptive capacity under adverse circumstances from natural disasters. [45][46][47] Given the influx of older adult visits to EDs after the storm, local hospitals should anticipate a range of needs typically provided by community-based services. These findings would be magnified by closure of local hospitals or outpatient clinics due to a storm, increasing the burden on emergency medical services workers, physicians, nurses, social workers, hospital administrators, disaster planners, and other medical professionals to meet older adults' disaster care needs.…”

Internal Hospital Crises and Disasters in The Netherlands, 2000-2020

“…Hospitals, and their EDs in particular, serve an important function in the community as wardens of public health in times of crisis and disaster [23]. IHCDs can directly cause physical harm and the sudden closure of a hospital or ED may force the diversion of patients to distant hospitals where patient records are lacking [24]. We have shown that hospital and departmental closures have occurred 134 times in the Netherlands with an increasing trend across a 20-year study period.…”

A Community Checklist for Health Sector Resilience Informed by Hurricane Sandy

“…17 The healthcare facilities that remained open, or that were able to quickly reopen, experienced high patient volumes—primarily treating people for minor or routine health problems. 18–20 …”