Short- and Long-Term Effects of Disasters on Seniors with Chronic Conditions

灾害对慢性病老年人的短期和长期影响

基本信息

批准号：
9317402
负责人：
Troy Quast
金额：
$ 7.48万
依托单位：
UNIVERSITY OF SOUTH FLORIDA
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-08-01 至 2019-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9317402
关键词：
Affect African American Aftercare Area Calories Caring Cessation of life Characteristics Chronic Comorbidity County Dangerousness Data Data Analyses Diabetes Mellitus Diagnosis Diet Disasters Distress Economics Elderly Endocrinologist Ethnic group Future Gender Geography Health Healthcare Hospitalization Human Hurricane Incidence Individual Inpatients Interruption Lead Long-Term Effects Louisiana Low income Medical Medicare Methods Modeling Outcome Outpatients Pharmaceutical Preparations Policies Population Preparation Prevalence Race Resources Risk Socioeconomic Status Specific qualifier value Time Treatment Protocols Variant base beneficiary diabetic disadvantaged population emotional shock experience gender difference gender disparity gulf coast health care service utilization improved insight medically necessary care mortality racial and ethnic racial and ethnic disparities response

项目摘要

Project Summary This project will investigate the short- and long-term effects on health care utilization and health outcomes of elderly diabetics affected by Hurricane Katrina. Over 1.5 million individuals were evacuated from the Gulf Coast due to Katrina and over 600,000 Medicare beneficiaries in Louisiana alone were affected by the storm. Seniors with diabetes were especially vulnerable to Katrina’s effects. Those affected were often unable to obtain medications, were forced to rely on replacement medications that didn’t necessarily match their needs, had to forgo necessary medical care, and experienced a lack of calories and abrupt diet changes. The analysis will employ individual-level data that identify Medicare beneficiaries with diabetes prior to Katrina in the affected areas and, for comparison purposes, in unaffected areas. The data cover the period 2002-2012, include demographic characteristics, and contain geographic information that will allow for the identification of seniors who were displaced from the affected areas. The data further specify by date the treatment received in outpatient and inpatient settings as well as prescription information Pre-post analyses will be performed across racial/ethnic groups within affected areas. Further analyses will compare individuals in affected versus unaffected areas utilizing a difference-in-differences econometric approach. The utilization analysis will examine whether there were interruptions in treatment by comparing the data in the period prior to Katrina to the period after landfall. The outcome analysis will investigate comorbidity incidence rates and mortality rates. All of the analysis will explore differences by gender and race. We expect to find that Hurricane Katrina had a significant, extended, and negative effect on seniors with diabetes. Many of these individuals had to forgo their typical treatment regimen and suffered from dramatic departures from their prescribed diet. It is further likely that these disruptions lead to increased hospitalization rates due to complications from lack of care. Finally, racial and ethnic disparities are likely present based on differences in socioeconomic status and resources available to devote to health care and well-being. Our study may provide useful information to medical professionals and policymakers. By identifying the magnitude of treatment disruptions and the associated negative health outcomes, we may assist in targeting the best response to treating senior diabetics in future disasters.

项目概要该项目将调查对医疗保健利用和健康结果的短期和长期影响受卡特里娜飓风影响的老年糖尿病患者从海湾地区撤离。仅路易斯安那州就有超过 600,000 名医疗保险受益人受到卡特里娜飓风的影响。患有糖尿病的老年人特别容易受到卡特里娜飓风的影响，受影响的人往往无法获得治疗。药物，被迫依赖不一定符合他们需求的替代药物，不得不放弃必要的医疗护理，并经历了热量缺乏和饮食突然改变。该分析将采用个人层面的数据，在医疗保险受益人之前识别出患有糖尿病的人。受卡特里娜飓风影响的地区以及出于比较目的，未受影响地区的数据涵盖了该时期。 2002-2012 年，包括人口统计特征，并包含地理信息，以便数据进一步明确了从受影响地区流离失所的老年人的身份。在门诊和住院环境中接受的治疗以及处方信息将在受影响地区的各个种族/族裔群体中进行事前分析。利用双重差异计量经济学比较受影响地区与未受影响地区的个人利用分析将通过比较来检查治疗是否存在中断。结果分析将调查卡特里娜飓风之前至登陆后期间的数据。所有分析都将探讨性别和种族的差异。我们预计卡特里娜飓风对患有以下疾病的老年人产生了重大、长期和负面的影响其中许多人不得不忘记他们的典型治疗方案，并遭受了严重的糖尿病。偏离规定的饮食可能会导致住院人数增加。最后，种族和民族差异可能是由于缺乏护理而引起的并发症。社会经济地位和可用于医疗保健和福祉的资源的差异。我们的研究可以通过识别来为医疗专业人员和政策制定者提供有用的信息。治疗中断的严重程度以及相关的负面健康结果，我们可以协助瞄准在未来灾难中治疗老年糖尿病的最佳应对措施。