Hospitalization Rates Among Dialysis Patients During Hurricane Katrina

2012 ◽  
Vol 27 (4) ◽  
pp. 325-329 ◽  
Author(s):  
David Howard ◽  
Rebecca Zhang ◽  
Yijian Huang ◽  
Nancy Kutner
Keyword(s):  
Hurricane Katrina ◽  
Large Scale ◽  
Service Use ◽  
Hospital Admissions ◽  
Gulf Coast ◽  
The United States ◽  
Time Varying ◽  
Dialysis Patients ◽  
Hospitalization Rates ◽  
The Impact

AbstractIntroductionDialysis 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.ProblemThe impact of Hurricane Katrina on hospitalization rates among dialysis patients was estimated.MethodsData 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.ResultsThe 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.ConclusionsHospitalization 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.

Characteristics of Physician Relocation Following Hurricane Katrina

2009 ◽  
Vol 95 (1) ◽  
pp. 6-12
Author(s):  
Kusuma Madamala ◽  
Claudia R. Campbell ◽  
Edbert B. Hsu ◽  
Yu-Hsiang Hsieh ◽  
James James
Keyword(s):  
Hurricane Katrina ◽  
Gulf Coast ◽  
General Medicine ◽  
The United States ◽  
Lessons Learned ◽  
Bivariate Analysis ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Factors Associated ◽  
The Impact

ABSTRACT Introduction: On Aug. 29, 2005, Hurricane Katrina made landfall along the Gulf Coast of the United States, resulting in the evacuation of more than 1.5 million people, including nearly 6000 physicians. This article examines the relocation patterns of physicians following the storm, determines the impact that the disaster had on their lives and practices, and identifies lessons learned. Methods: An Internet-based survey was conducted among licensed physicians reporting addresses within Federal Emergency Management Agency-designated disaster zones in Louisiana and Mississippi. Descriptive data analysis was used to describe respondent characteristics. Multivariate logistic regression was performed to identify the factors associated with physician nonreturn to original practice. For those remaining relocated out of state, bivariate analysis with x2 or Fisher exact test was used to determine factors associated with plans to return to original practice. Results: A total of 312 eligible responses were collected. Among disaster zone respondents, 85.6 percent lived in Louisiana and 14.4 percent resided in Mississippi before the hurricane struck. By spring 2006, 75.6 percent (n = 236) of the respondents had returned to their original homes, whereas 24.4 percent (n = 76) remained displaced. Factors associated with nonreturn to original employment included family or general medicine practice (OR 0.42, 95 percent CI 0.17–1.04; P = .059) and severe or complete damage to the workplace (OR 0.24, 95 percent CI 0.13–0.42; P &lt; .001). Conclusions: A sizeable proportion of physicians remain displaced after Hurricane Katrina, along with a lasting decrease in the number of physicians serving in the areas affected by the disaster. Programs designed to address identified physician needs in the aftermath of the storm may give confidence to displaced physicians to return.

scholarly journals Hurricane Katrina (2005). Part I: Complex Life Cycle of an Intense Tropical Cyclone

2007 ◽  
Vol 135 (12) ◽  
pp. 3905-3926 ◽  
Author(s):  
Ron McTaggart-Cowan ◽  
Lance F. Bosart ◽  
John R. Gyakum ◽  
Eyad H. Atallah
Keyword(s):  
Life Cycle ◽  
Gulf Of Mexico ◽  
Hurricane Katrina ◽  
Gulf Coast ◽  
The United States ◽  
Historical Record ◽  
Complex Life Cycle ◽  
Loop Current ◽  
The Bahamas ◽  
The Impact

Abstract The devastating effects of Hurricane Katrina (2005) on the Gulf Coast of the United States are without compare for natural disasters in recent times in North America. With over 1800 dead and insured losses near $40 billion (U.S. dollars), Katrina ranks as the costliest and one of the deadliest Atlantic hurricanes in history. This study documents the complex life cycle of Katrina, a storm that was initiated by a tropical transition event in the Bahamas. Katrina intensified to a category-1 hurricane shortly before striking Miami, Florida; however, little weakening was observed as the system crossed the Florida peninsula. An analog climatology is used to show that this behavior is consistent with the historical record for storms crossing the southern extremity of the peninsula. Over the warm Gulf of Mexico waters, Katrina underwent two periods of rapid intensification associated with a warm core ring shed by the Loop Current. Between these spinup stages, the storm doubled in size, leading to a monotonic increase in power dissipation until Katrina reached a superintense state on 28 September. A pair of extremely destructive landfalls in Louisiana followed the weakening of the system over shelf waters. Despite its strength as a hurricane, Katrina did not reintensify following extratropical transition. The evolution of the storm’s outflow anticyclone, however, led to a perturbation of the midlatitude flow that is shown in a companion study to influence the Northern Hemisphere over a period of 2 weeks. An understanding of the varied components of Katrina’s complex evolution is necessary for further developing analysis and forecasting techniques as they apply to storms that form near the North American continent and rapidly intensify over the Gulf of Mexico. Given the observed overall increase in Atlantic hurricane activity since the mid-1990s, an enhanced appreciation for the forcings involved in such events could help to mitigate the impact of similar severe hurricanes in the future.

scholarly journals MO031EFFECTS OF PREDICTIVE MODELLING RISK DIRECTED INTERVENTIONS ON HOSPITALIZATION RATES IN HAEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Sheetal Chaudhuri ◽  
Sophia Rosen ◽  
John Larkin ◽  
Len A Usvyat ◽  
David Sweet ◽  
...  
Keyword(s):  
High Risk ◽  
Hospital Admission ◽  
Predictive Model ◽  
Hospital Admissions ◽  
Interdisciplinary Team ◽  
The United States ◽  
South Florida ◽  
Low Risk ◽  
Hospitalization Rates ◽  
The Impact

Abstract Background and Aims End Stage Kidney Disease (ESKD) patients have high hospitalization rates. We have developed and deployed a predictive model to identify in-centre haemodialysis (HD) patients at an increased risk for all-cause hospitalization within the next 12 months. The model was used in a pilot called Dialysis Hospitalization Reduction Program (DHRP) to identify patients predicted to be at risk of &gt;=6 hospital admissions and provide additional interdisciplinary team intervention. We investigated the impact of the DHRP on hospitalization rates in HD patients. Method We used data from 45 clinics in South Alabama/Florida Panhandle regions of the United States who participated in DHRP pilot starting January 2016. The predictive model used more than 200 variables to stratify patients as high risk (&gt;=6 admissions), medium high risk (&gt;=3 admissions) and medium low risk (&gt;=1 admission) and low risk (&lt;1 admission). For patients identified at high risk of hospitalization, social workers assessed psychosocial barriers and offered additional psychosocial intervention to target those barriers. Dietitians utilized a high risk assessment looking at weight, nutrition, and access to food and supplements. Resident nurses assessed high risk patients focusing on anaemia, adequacy, access, blood pressure, fluid management, prior hospitalizations, glycaemic control and risk of skin ulcers and blood stream infection Data from patients at the participating clinics was collected and yearly hospital admission and day rates per patient year were calculated 2 years prior to (2014, 2015) and 3 years after (2016-2018) pilot start. Comparison clinics were chosen from neighbouring regions in South and North Florida (43 and 45 clinics respectively). Results Over the study period the number of patients ranged from 4661 to 5672 in the DHRP pilot clinics, 5416 to 5947 in South Florida control clinics, and 6087 to 7596 in North Florida control clinics. Hospitalization rates in pilot clinics during the first year of the DHRP remined similar to the rates during the two years preceding the pilot start. In the second and third years of the DHRP, pilot clinics showed reductions in hospital admission and day rates. At control clinics in both regions the hospital admissions and day rates showed increasing trends while DHRP clinics showed decreasing trends over the study period (Figures 1a and 1b). Conclusion These findings suggest predictive model risk directed interdisciplinary team interventions associate with lower hospitalization rates in HD patients, compared to controls. Further studies are needed to confirm these results.

The 2006 New Orleans Mayoral Election: The Political Ramifications of a Large-Scale Natural Disaster

2008 ◽  
Vol 41 (04) ◽  
pp. 795-801 ◽  
Author(s):  
James Vanderleeuw ◽  
Baodong Liu ◽  
Erica Williams
Keyword(s):  
Hurricane Katrina ◽  
New Orleans ◽  
Sea Level ◽  
Storm Surge ◽  
Large Scale ◽  
Gulf Coast ◽  
The United States ◽  
The Bahamas ◽  
Mayoral Election ◽  
The City

On Monday, August 29, 2005, the Gulf Coast of the United States was hit by the sixth most destructive Atlantic hurricane on record, Hurricane Katrina. Katrina formed in the Bahamas on August 23 and entered the Gulf of Mexico two days later, on the twenty-fifth (Knabb 2005). Twelve hours after entering the gulf, Katrina grew from a Category 3 to a Category 5 storm on the Saffir-Simpson scale, with winds up to 160 miles per hour. Katrina made landfall on the twenty-ninth as a powerful Category 3 storm with winds up to 145 miles per hour. However, once Katrina made landfall she maintained a storm surge equivalent to a Category 5 storm. For the city of New Orleans, the greatest threat without question was to be from the storm surge. Lake Pontchartrain—which normally sits at one foot above sea level—was elevated to eight and a half feet above sea level. On Tuesday, August 30, the city's levees broke in three places—along the Industrial Canal, the 17thStreet Canal, and the London Street Canal (Mihelich 2005). As a result, 80% of the city was flooded, in some places with water as high as 20 feet above sea level (Knabb 2005).

Diabetes Discharge Planning and Transitions of Care: A Focused Review

2019 ◽  
Vol 15 (2) ◽  
pp. 111-117 ◽  
Author(s):  
Robin L. Black ◽  
Courtney Duval
Keyword(s):  
Patient Outcomes ◽  
Hospital Admissions ◽  
Discharge Planning ◽  
Medication Management ◽  
Hospital Readmissions ◽  
The United States ◽  
Transitions Of Care ◽  
Discharge Process ◽  
The Impact ◽  
Diabetes Patients

Background: Diabetes is a growing problem in the United States. Increasing hospital admissions for diabetes patients demonstrate the need for evidence-based care of diabetes patients by inpatient providers, as well as the importance of continuity of care when transitioning patients from inpatient to outpatient providers. Methods: A focused literature review of discharge planning and transitions of care in diabetes, conducted in PubMed is presented. Studies were selected for inclusion based on content focusing on transitions of care in diabetes, risk factors for readmission, the impact of inpatient diabetes education on patient outcomes, and optimal medication management of diabetes during care transitions. American Diabetes Association (ADA) guidelines for care of patients during the discharge process are presented, as well as considerations for designing treatment regimens for a hospitalized patient transitioning to various care settings. Results: Multiple factors may make transitions of care difficult, including poor communication, poor patient education, inappropriate follow-up, and clinically complex patients. ADA recommendations provide guidance, but an individualized approach for medication management is needed. Use of scoring systems may help identify patients at higher risk for readmission. Good communication with patients and outpatient providers is needed to prevent patient harm. A team-based approach is needed, utilizing the skills of inpatient and outpatient providers, diabetes educators, nurses, and pharmacists. Conclusion: Structured discharge planning per guideline recommendations can help improve transitions in care for patients with diabetes. A team based, patient-centered approach can help improve patient outcomes by reducing medication errors, delay of care, and hospital readmissions.

Situational Breakdowns

2019 ◽  
Author(s):  
Anne Nassauer
Keyword(s):  
United States ◽  
Large Scale ◽  
Contextual Factors ◽  
The United States ◽  
Social Outcomes ◽  
Dynamic Processes ◽  
Collective Decisions ◽  
Different Types ◽  
The Impact

This book provides an account of how and why routine interactions break down and how such situational breakdowns lead to protest violence and other types of surprising social outcomes. It takes a close-up look at the dynamic processes of how situations unfold and compares their role to that of motivations, strategies, and other contextual factors. The book discusses factors that can draw us into violent situations and describes how and why we make uncommon individual and collective decisions. Covering different types of surprise outcomes from protest marches and uprisings turning violent to robbers failing to rob a store at gunpoint, it shows how unfolding situations can override our motivations and strategies and how emotions and culture, as well as rational thinking, still play a part in these events. The first chapters study protest violence in Germany and the United States from 1960 until 2010, taking a detailed look at what happens between the start of a protest and the eruption of violence or its peaceful conclusion. They compare the impact of such dynamics to the role of police strategies and culture, protesters’ claims and violent motivations, the black bloc and agents provocateurs. The analysis shows how violence is triggered, what determines its intensity, and which measures can avoid its outbreak. The book explores whether we find similar situational patterns leading to surprising outcomes in other types of small- and large-scale events: uprisings turning violent, such as Ferguson in 2014 and Baltimore in 2015, and failed armed store robberies.

scholarly journals Modeling regional impacts and resilience to water service disruptions in urban economies

2021 ◽  
pp. 239980832199870
Author(s):  
Sheree A Pagsuyoin ◽  
Joost R Santos
Keyword(s):  
Case Studies ◽  
Large Scale ◽  
Urban Region ◽  
Economic Losses ◽  
Drought Severity ◽  
Severe Drought ◽  
Time Varying ◽  
National Capital Region ◽  
Economic Sectors ◽  
The Impact

Water is a critical natural resource that sustains the productivity of many economic sectors, whether directly or indirectly. Climate change alongside rapid growth and development are a threat to water sustainability and regional productivity. In this paper, we develop an extension to the economic input-output model to assess the impact of water supply disruptions to regional economies. The model utilizes the inoperability variable, which measures the extent to which an infrastructure system or economic sector is unable to deliver its intended output. While the inoperability concept has been utilized in previous applications, this paper offers extensions that capture the time-varying nature of inoperability as the sectors recover from a disruptive event, such as drought. The model extension is capable of inserting inoperability adjustments within the drought timeline to capture time-varying likelihoods and severities, as well as the dependencies of various economic sectors on water. The model was applied to case studies of severe drought in two regions: (1) the state of Massachusetts (MA) and (2) the US National Capital Region (NCR). These regions were selected to contrast drought resilience between a mixed urban–rural region (MA) and a highly urban region (NCR). These regions also have comparable overall gross domestic products despite significant differences in the distribution and share of the economic sectors comprising each region. The results of the case studies indicate that in both regions, the utility and real estate sectors suffer the largest economic loss; nonetheless, results also identify region-specific sectors that incur significant losses. For the NCR, three sectors in the top 10 ranking of highest economic losses are government-related, whereas in the MA, four sectors in the top 10 are manufacturing sectors. Furthermore, the accommodation sector has also been included in the NCR case intuitively because of the high concentration of museums and famous landmarks. In contrast, the Wholesale Trade sector was among the sectors with the highest economic losses in the MA case study because of its large geographic size conducive for warehouses used as nodes for large-scale supply chain networks. Future modeling extensions could potentially include analysis of water demand and supply management strategies that can enhance regional resilience against droughts. Other regional case studies can also be pursued in future efforts to analyze various categories of drought severity beyond the case studies featured in this paper.

scholarly journals 1719. Respiratory Syncytial Virus-Associated Hospitalization Rates among US Infants: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S843-S843
Author(s):  
John M McLaughlin ◽  
Farid L Khan ◽  
Heinz-Josef Schmitt ◽  
Yasmeen Agosti ◽  
Luis Jodar ◽  
...  
Keyword(s):  
Public Health ◽  
Respiratory Syncytial Virus ◽  
Active Surveillance ◽  
Meta Analysis ◽  
The United States ◽  
Administrative Claims ◽  
Prevention Strategies ◽  
Hospitalization Rates ◽  
Syncytial Virus ◽  
The Impact

Abstract Background Understanding the true magnitude of infant respiratory syncytial virus (RSV) burden is critical for determining the potential public-health benefit of RSV prevention strategies. Although global reviews of infant RSV burden exist, none have summarized data from the United States or evaluated how RSV burden estimates are influenced by variations in study design. Methods We performed a systematic literature review and meta-analysis of studies describing RSV-associated hospitalization rates among US infants. We also examined the impact of key study characteristics on these estimates. Results After review of 3058 articles through January 2020, we identified 25 studies with 31 unique estimates of RSV-associated hospitalization rates. Among US infants &lt; 1 year of age, annual rates ranged from 8.4 to 40.8 per 1000 with a pooled rate= 19.4 (95%CI= 17.9–20.9). Study type was associated with RSV hospitalization rates (P =.003), with active surveillance studies having pooled rates per 1000 (11.1; 95%CI: 9.8–12.3) that were half that of studies based on administrative claims (21.4; 95%CI: 19.5–23.3) or modeling approaches (23.2; 95%CI: 20.2–26.2). Conclusion Applying the pooled rates identified in our review to the 2020 US birth cohort suggests that 73,680 to 86,020 RSV-associated infant hospitalizations occur each year. To date, public-health officials have used conservative estimates from active surveillance as the basis for defining US infant RSV burden. The full range of RSV-associated hospitalization rates identified in our review better characterizes the true RSV burden in infants and can better inform future evaluations of RSV prevention strategies. Disclosures John M. McLaughlin, PhD, Pfizer (Employee, Shareholder) Farid L. Khan, MPH, Pfizer (Employee, Shareholder) Heinz-Josef Schmitt, MD, Pfizer (Employee, Shareholder) Yasmeen Agosti, MD, Pfizer (Employee, Shareholder) Luis Jodar, PhD, Pfizer (Employee, Shareholder) Eric Simões, MD, Pfizer (Consultant, Research Grant or Support) David L. Swerdlow, MD, Pfizer (Employee, Shareholder)

scholarly journals Assessment of Impacts of Hurricane Katrina on Net Primary Productivity in Mississippi

2010 ◽  
Vol 14 (14) ◽  
pp. 1-12 ◽  
Author(s):  
Shrinidhi Ambinakudige ◽  
Sami Khanal
Keyword(s):  
Natural Disasters ◽  
Hurricane Katrina ◽  
Primary Productivity ◽  
Atmospheric Carbon Dioxide ◽  
Net Primary Productivity ◽  
Gulf Coast ◽  
Carbon Sink ◽  
Anthropogenic Activities ◽  
Remote Sensing Data ◽  
The United States

Abstract Southern forests contribute significantly to the carbon sink for the atmospheric carbon dioxide (CO2) associated with the anthropogenic activities in the United States. Natural disasters like hurricanes are constantly threatening these forests. Hurricane winds can have a destructive impact on natural vegetation and can adversely impact net primary productivity (NPP). Hurricane Katrina (23–30 August 2005), one of the most destructive natural disasters in history, has affected the ecological balance of the Gulf Coast. This study analyzed the impacts of different categories of sustained winds of Hurricane Katrina on NPP in Mississippi. The study used the Carnegie–Ames–Stanford Approach (CASA) model to estimate NPP by using remote sensing data. The results indicated that NPP decreased by 14% in the areas hard hit by category 3 winds and by 1% in the areas hit by category 2 winds. However, there was an overall increase in NPP, from 2005 to 2006 by 0.60 Tg of carbon, in Mississippi. The authors found that Pearl River, Stone, Hancock, Jackson, and Harrison counties in Mississippi faced significant depletion of NPP because of Hurricane Katrina.

scholarly journals Impact of the first COVID-19 shelter-in-place order in the United States on emergency department utilization, Marin County, California

2020 ◽  
Author(s):  
Brett R. Bayles ◽  
Michaela F George ◽  
Haylea Hannah ◽  
Patti Culross ◽  
Rochelle R. Ereman ◽  
...  
Keyword(s):  
United States ◽  
San Francisco ◽  
Large Scale ◽  
Temporal Dynamics ◽  
The United States ◽  
Emergency Department Utilization ◽  
Marin County ◽  
Before And After ◽  
Ed Visits ◽  
The Impact

Background: The first shelter-in-place (SIP) order in the United States was issued across six counties in the San Francisco Bay Area to reduce the impact of COVID-19 on critical care resources. We sought to assess the impact of this large-scale intervention on emergency departments (ED) in Marin County, California. Methods: We conducted a retrospective descriptive and trend analysis of all ED visits in Marin County, California from January 1, 2018 to May 4, 2020 to quantify the temporal dynamics of ED utilization before and after the March 17, 2020 SIP order. Results: The average number of ED visits per day decreased by 52.3% following the SIP order compared to corresponding time periods in 2018 and 2019. Both respiratory and non-respiratory visits declined, but this negative trend was most pronounced for non-respiratory admissions. Conclusions: The first SIP order to be issued in the United States in response to COVID-19 was associated with a significant reduction in ED utilization in Marin County.

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