Health of Medicare Advantage plan enrollees at 1 year after Hurricane Katrina.
OBJECTIVE
To assess the effects of Hurricane Katrina on mortality, morbidity, disease prevalence, and service utilization during 1 year in a cohort of 20,612 older adults who were living in New Orleans, Louisiana, before the disaster and who were enrolled in a managed care organization (MCO).


METHODS
Observational study comparing mortality, morbidity, and service use for 1 year before and after Hurricane Katrina, augmented by a stratified random sample of 303 enrollees who participated in a telephone survey after Hurricane Katrina.


METHODS
Sources of data for health and service use were MCO claims. Mortality was based on reports to the MCO from the Centers for Medicare & Medicaid Services; morbidity was measured using adjusted clinical groups case-mix methods derived from diagnoses in ambulatory and hospital claims data.


RESULTS
Mortality in the year following Hurricane Katrina was not significantly elevated (4.3% before vs 4.9% after the hurricane). However, overall morbidity increased by 12.6% (P <.001) compared with a 3.4% increase among a national sample of Medicare managed care enrollees. Nonwhite subjects from Orleans Parish experienced a morbidity increase of 15.9% (P <.001). The prevalence of numerous treated medical conditions increased, and emergency department visits and hospitalizations remained significantly elevated during the year.


CONCLUSIONS
The enormous health burden experienced by older individuals and the disruptions in service utilization reveal the long-term effects of Hurricane Katrina on this vulnerable population. Although quick rebuilding of the provider network may have attenuated more severe health outcomes for this managed care population, new policies must be introduced to deal with the health consequences of a major disaster.
Burton
Lynda C
LC
Johns Hopkins University Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD 21205, USA. lburton@jhsph.edu
Skinner
Elizabeth A
EA
Uscher-Pines
Lori
L
Lieberman
Richard
R
Leff
Bruce
B
Clark
Rebecca
R
Yu
Qilu
Q
Lemke
Klaus W
KW
Weiner
Jonathan P
JP
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D055867:Cyclonic Storms; D004190:Disasters / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008329:Managed Care Programs / Q000706:statistics & numerical data*; D020398:Medicare Part C / Q000706:statistics & numerical data*; D055820:New Orleans / Q000453:epidemiology; D014481:United States / Q000453:epidemiology