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A comparative analysis of two external health care disaster responses following Hurricane Katrina
Michael G Millin1, Jennifer L Jenkins, Thomas Kirsch
1Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21209-3652, USA. millin@jhmi.edu
Objective:
Hurricane Katrina severely disrupted the health services in the U.S. Gulf Coast, necessitating an external health care response. The types and needs of patients following such an extensive event have not been well described. The objective of this study was to analyze the types of patients treated in two temporary clinics and to identify differences between them.
Methods:
Two temporary sites were established: a disaster medical assistance team-based site in Mississippi and a volunteer-based site near New Orleans. Data were abstracted from patient charts for the two days of simultaneous operation: September 11 and 12, 2005. Each patient's age group, disposition, and primary discharge diagnosis was categorized and analyzed with descriptive and comparative statistics.
Results:
There were a total of 501 patient encounters. The most common presentation overall was for chronic health conditions such as medication refills (20.6%), immunizations (11.0%), obtaining community resources (6.0%). and management of acute exacerbation of chronic hypertension (4.6%). There were important differences; the Mississippi site treated more acute conditions than the Louisiana site, including lacerations (13.7% vs. 0%; p < 0.001), musculosketal injuries (9.4% vs. 2.6%; p < 0.001), and other nonspecified injuries (3.0% vs. 0.4%; p = 0.020).
Conclusions:
With extensive damage to a health care system, these temporary clinics staffed by out-of-state volunteers provided needed health care. The most common health problems were related to chronic disease, primary health care, and routine emergency care, not to the direct impact of the hurricane. In addition to treating minor injuries, disaster planners should prepare to provide primary health care, administer vaccinations, and provide missing long-term medications.
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