Disasters and the public health safety net: Hurricane Floyd hits the North Carolina Medicaid program.
OBJECTIVE
We measured the effect of Hurricane Floyd on Medicaid enrollment and health services use in the most severely affected counties of North Carolina.


METHODS
We used differences-in-differences models on balanced panels of Medicaid claims and enrollment data.


RESULTS
Overall spending per enrollee showed little short-term effect but demonstrated a moderate increase 1 year after the storm. We found very modest short-term increases in Medicaid enrollment, a small long-term decrease in enrollment, and large increases in the long-term use of emergency room and outpatient services.


CONCLUSIONS
Our findings suggest that hurricane victims experienced substantial changes in patterns of care that endured for much longer than the initial crisis period. These findings can have important implications for the management of disaster relief for this population.
Domino
Marisa Elena
ME
Department of Health Policy and Administration, School of Public Health, University of North Carolina, Chapel Hill, 27599-7411, USA. domino@unc.edu
Fried
Bruce
B
Moon
Yoosun
Y
Olinick
Joshua
J
Yoon
Jangho
J
D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D004190:Disasters / Q000191:economics*; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D019538:Health Care Surveys; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D008484:Medicaid / Q000706:statistics & numerical data*; D009657:North Carolina / Q000453:epidemiology; D013221:State Health Plans / Q000191:economics / Q000706:statistics & numerical data*; D014481:United States