Providing continuity of care for chronic diseases in the aftermath of Katrina: from field experience to policy recommendations.
This study sought to elicit challenges and solutions in the provision of health care to those with chronic diseases after Hurricane Katrina in coastal Alabama and Mississippi. In-depth interviews with 30 health and social service providers (key informants) and 4 focus groups with patients with chronic diseases were conducted. Subsequently an advisory panel of key informants was convened. Findings were summarized and key informants submitted additional feedback. The chronic diseases identified as medical management priorities by key informants were mental health, diabetes mellitus, hypertension, respiratory illness, end-stage renal disease, cardiovascular disease, and cancer. The most frequently mentioned barrier to providing care was maintaining continuity of medications. Contributing factors were inadequate information (inaccessible medical records, poor patient knowledge) and financial constraints. Implemented or suggested solutions included relaxation of insurance limitations preventing advance prescription refills; better predisaster patient education to improve medical knowledge; promotion of personal health records; support for information technology systems at community health centers, in particular electronic medical records; improved allocation of donated medications/medical supplies (centralized coordination, decentralized distribution); and networking between local responders and external aid.
Center for Healthy Communities and Department of Internal Medicine, University of South Alabama, Alabama, USA. marrieta@usouthal.edu
Martha I
MI
Arrieta
Rachel D
RD
Foreman
Errol D
ED
Crook
Marjorie L
ML
Icenogle
D000407:Alabama; D002908:Chronic Disease / Q000453:epidemiology* / Q000628:therapy; D003266:Continuity of Patient Care / Q000458:organization & administration*; D055867:Cyclonic Storms; D003695:Delivery of Health Care / Q000458:organization & administration*; D004189:Disaster Planning; D004190:Disasters; D017144:Focus Groups; D006291:Health Policy; D006297:Health Services Accessibility; D006801:Humans; D007256:Information Systems / Q000706:statistics & numerical data; D007407:Interviews as Topic; D008922:Mississippi; D019982:Organizational Case Studies; D011320:Primary Health Care / Q000458:organization & administration; D012947:Social Work