Hostname: page-component-8448b6f56d-c47g7 Total loading time: 0 Render date: 2024-04-15T14:00:35.472Z Has data issue: false hasContentIssue false
  • English
  • Français

Hospitalization Rates Among Dialysis Patients During Hurricane Katrina

Published online by Cambridge University Press:  19 July 2012

David Howard ,
Rebecca Zhang ,
Yijian Huang  and
Nancy Kutner
David Howard*
Affiliation:
Department of Health Policy and Management, Department of Economics, Emory University, Atlanta, Georgia USA
Rebecca Zhang
Affiliation:
Department of Biostatistics, Emory University, Atlanta, Georgia USA
Yijian Huang
Affiliation:
Department of Biostatistics, Emory University, Atlanta, Georgia USA
Nancy Kutner
Affiliation:
Department of Rehabilitation Medicine, Department of Sociology, Emory University, Atlanta, Georgia USA
*
Correspondence: David Howard, PhD Department of Health Policy and Management Emory University 1518 Clifton Road NE Atlanta, GA 30322 USA E-mail david.howard@emory.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction

Dialysis centers struggled to maintain continuity of care for dialysis patients during and immediately following Hurricane Katrina's landfall on the US Gulf Coast in August 2005. However, the impact on patient health and service use is unclear.

Problem

The impact of Hurricane Katrina on hospitalization rates among dialysis patients was estimated.

Methods

Data from the United States Renal Data System were used to identify patients receiving dialysis from January 1, 2001 through August 29, 2005 at clinics that experienced service disruptions during Hurricane Katrina. A repeated events duration model was used with a time-varying Hurricane Katrina indicator to estimate trends in hospitalization rates. Trends were estimated separately by cause: surgical hospitalizations, medical, non-renal-related hospitalizations, and renal-related hospitalizations.

Results

The rate ratio for all-cause hospitalization associated with the time-varying Hurricane Katrina indicator was 1.16 (95% CI, 1.05-1.29; P = .004). The ratios for cause-specific hospitalization were: surgery, 0.84 (95% CI, 0.68-1.04; P = .11); renal-related admissions, 2.53 (95% CI, 2.09-3.06); P < .001), and medical non-renal related, 1.04 (95% CI, 0.89-1.20; P = .63). The estimated number of excess renal-related hospital admissions attributable to Katrina was 140, representing approximately three percent of dialysis patients at the affected clinics.

Conclusions

Hospitalization rates among dialysis patients increased in the month following the Hurricane Katrina landfall, suggesting that providers and patients were not adequately prepared for large-scale disasters.

Howard D, Zhang R, Huang Y, Kutner N. Hospitalization rates among dialysis patients during Hurricane Katrina. Prehosp Disaster Med. 2012;27(4):1-5.

Keywords

dialysisdisasterend-stagehospitalizationLouisianarenal disease
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 27 , Issue 4 , August 2012 , pp. 325 - 329
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Kenney, RJZ. Emergency preparedness concepts for dialysis facilities: reawakened after Hurricane Katrina. Clin J Am Soc Nephrol. 2007;2(4):809-813.CrossRefGoogle ScholarPubMed
2. Kleinpeter, MA, Norman, LD, Krane, NK. Dialysis services in the hurricane-affected areas in 2005: lessons learned. Am J Med Sci. 2006;332(5):259-263.CrossRefGoogle ScholarPubMed
3. Anderson, AH, Cohen, AJ, Kutner, NG, Kopp, JB, Kimmel, PL, Muntner, P. Missed dialysis sessions and hospitalization in hemodialysis patients after Hurricane Katrina. Kidney Int. 2009;75(11):1202-1208.Google Scholar
4. Hyre, AD, Cohen, AJ, Kutner, NG, et al. . Psychosocial status of hemodialysis patients one year after Hurricane Katrina. Am J Med Sci. 2008;336(2):94-98.CrossRefGoogle ScholarPubMed
5. U.S. Renal Data System. USRDS 2007 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States. Bethesda, Maryland USA: US National Institute of Diabetes and Digestive and Kidney Diseases; 2007.Google Scholar
6. Kutner, NG, Muntner, P, Huang, Y, et al. . Effect of Hurricane Katrina on the mortality of dialysis patients. Kidney Int. 2009;76(7):760-766.Google Scholar
7. Kopp, JB, Ball, LK, Cohen, A, et al. . Kidney patient care in disasters: lessons from the hurricanes and earthquake of 2005. Clin J Am Soc Nephrol. 2007;2(4):814-824.Google Scholar
8. U.S. Renal Data System. USRDS 2009 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States. Bethesda, Maryland USA: US National Institute of Diabetes and Digestive and Kidney Diseases; 2009.Google Scholar
9. Sehgal, AR. Outcomes of renal replacement therapy among blacks and women. Am J Kid Dis. 2000;35(4 Suppl 1):S148-S152.CrossRefGoogle ScholarPubMed