Hospitalization rates among dialysis patients during Hurricane Katrina.
BACKGROUND
Dialysis centers struggled to maintain continuity of care for dialysis patients during and immediately following Hurricane Katrina's landfall on the US Gulf Coast in August 2005. However, the impact on patient health and service use is unclear.


OBJECTIVE
The impact of Hurricane Katrina on hospitalization rates among dialysis patients was estimated.


METHODS
Data from the United States Renal Data System were used to identify patients receiving dialysis from January 1, 2001 through August 29, 2005 at clinics that experienced service disruptions during Hurricane Katrina. A repeated events duration model was used with a time-varying Hurricane Katrina indicator to estimate trends in hospitalization rates. Trends were estimated separately by cause: surgical hospitalizations, medical, non-renal-related hospitalizations, and renal-related hospitalizations.


RESULTS
The rate ratio for all-cause hospitalization associated with the time-varying Hurricane Katrina indicator was 1.16 (95% CI, 1.05-1.29; P = .004). The ratios for cause-specific hospitalization were: surgery, 0.84 (95% CI, 0.68-1.04; P = .11); renal-related admissions, 2.53 (95% CI, 2.09-3.06); P < .001), and medical non-renal related, 1.04 (95% CI, 0.89-1.20; P = .63). The estimated number of excess renal-related hospital admissions attributable to Katrina was 140, representing approximately three percent of dialysis patients at the affected clinics.


CONCLUSIONS
Hospitalization rates among dialysis patients increased in the month following the Hurricane Katrina landfall, suggesting that providers and patients were not adequately prepared for large-scale disasters.
Department of Health Policy and Management, Department of Economics, Emory University, Atlanta, Georgia 30322, USA. david.howard@emory.edu
David
D
Howard
Rebecca
R
Zhang
Yijian
Y
Huang
Nancy
N
Kutner
D000407:Alabama; D003266:Continuity of Patient Care; D055867:Cyclonic Storms; D004189:Disaster Planning; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008145:Louisiana; D008297:Male; D008875:Middle Aged; D008922:Mississippi; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D014481:United States