Prehospital and Disaster Medicine

Original Research

Hospitalization Rates Among Dialysis Patients During Hurricane Katrina

David Howarda1 c1, Rebecca Zhanga2, Yijian Huanga2 and Nancy Kutnera3

a1 Department of Health Policy and Management, Department of Economics, Emory University, Atlanta, Georgia USA

a2 Department of Biostatistics, Emory University, Atlanta, Georgia USA

a3 Department of Rehabilitation Medicine, Department of Sociology, Emory University, Atlanta, Georgia USA

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.

(Received April 25 2011)

(Accepted June 29 2011)

(Revised July 20 2011)

(Online publication July 19 2012)

Correspondence:

c1 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

Footnotes

Funding: This study was funded by the US Centers for Disease Control and Prevention (1U01IP000411-01).