How many walked through the door?: the effect of hurricane Katrina evacuees on Houston emergency departments.
BACKGROUND
Hurricane Katrina necessitated the evacuation of over 200,000 New Orleans residents into Houston in the days after landfall. The already stressed emergency departments (EDs) were faced with a potential influx of patients suffering injuries and conditions exacerbated by the hurricane and resulting devastation.


OBJECTIVE
To examine the effect of Katrina evacuees on Houston EDs after the hurricane.


METHODS
Data from visits to 25 Houston EDs in 2005 (n = 875,750) were analyzed to evaluate the impact of visits by Katrina evacuees (n = 8427).


METHODS
Descriptive counts of ED visits by individuals with a FEMA designated disaster area zip code due to Katrina.


RESULTS
In September, immediately after Katrina, Houston-area EDs reported the lowest monthly total visits in 2005 despite treating 4518 evacuees that month. On aggregate, the increase in visits by evacuees did not overwhelm area EDs, as they coincided with a decrease in ED utilization by nonevacuees and over 20,000 evacuees were seen at medical clinics in the large shelters. The highest number of evacuee visits to an individual ED was 86, on September 1. The peak day of visits, totaling 364, occurred on September 3. The ED that bore 15% of total visits saw no more than 19 evacuees daily. Evacuee and nonevacuee visits dropped dramatically when hurricane Rita threatened Houston.


CONCLUSIONS
Houston EDs experienced an increase in visits by Katrina evacuees in the hurricane's aftermath. However, the initial surge of visits was modest and corresponded with decreases in visits by nonevacuees and medical care provided in large shelters.
Mortensen
Karoline
K
Department of Political Science MS-24, Rice University, Houston, Texas, USA. kmort@rice.edu
Dreyfuss
Zachary
Z
D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004190:Disasters / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006302:Health Services Research / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D008145:Louisiana; D009017:Morbidity; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data; D012036:Refugees / Q000706:statistics & numerical data*; D012066:Relief Work / Q000706:statistics & numerical data*; D013781:Texas; D017664:Uncompensated Care / Q000706:statistics & numerical data; D014600:Utilization Review / Q000706:statistics & numerical data