title: Cross-Sectional Study of the Impact of a Natural Disaster on the Delivery of Gynecologic Oncology Care.
abstract: OBJECTIVE
  We aimed to compare access to gynecologic oncology care at a private and a city hospital, both of which closed for a period of time because of Hurricane Sandy.
  
  
  METHODS
  This was a cross-sectional study of gynecologic oncology chemotherapy, radiotherapy, and surgical patients from October 29, 2012 (the eve of the storm), to February 7, 2013 (the reopening of the city hospital). New referrals during this time were excluded. Delays in chemotherapy, radiotherapy, and surgery were compared.
  
  
  RESULTS
  Analysis included 113 patients: 59 private patients (52.2%) and 54 city patients (47.8%). Of the private patients, 33/59 received chemotherapy (55.9%), 1/59 received radiotherapy (1.7%), and 28/59 had planned surgery (47.5%). Of the city patients, 40/54 received chemotherapy (74.1%), 7/54 received radiotherapy (12.3%), and 18/54 had planned surgery (33.3%). The mean delay in chemotherapy was 7.6 days at the private hospital and 21.7 days at the city hospital (P=0.0004). The mean delay in scheduled surgery was 14.2 days at the private hospital and 22.7 days at the city hospital (P=0.3979). The mean delay in radiotherapy was 0.0 days at the private hospital and 25.0 days at the city hospital (P=0.0046). Loss to follow-up rates were 3/59 of the private patients (5.1%) and 3/54 of the city patients (5.6%).
  
  
  CONCLUSIONS
  Gynecologic oncology care was maintained during a natural disaster despite temporary closure and relocation of services. Disparity in care was in access to chemotherapy.
authors.affiliation: Division of Gynecologic Oncology,New York University Langone Medical Center,New York,New York.
authors.forename: Gizelka
authors.initials: G
authors.lastname: David-West
authors.affiliation: Division of Gynecologic Oncology,New York University Langone Medical Center,New York,New York.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Musa
authors.affiliation: Division of Gynecologic Oncology,New York University Langone Medical Center,New York,New York.
authors.forename: Melissa K
authors.initials: MK
authors.lastname: Frey
authors.affiliation: Division of Gynecologic Oncology,New York University Langone Medical Center,New York,New York.
authors.forename: Leslie
authors.initials: L
authors.lastname: Boyd
authors.affiliation: Division of Gynecologic Oncology,New York University Langone Medical Center,New York,New York.
authors.forename: Bhavana
authors.initials: B
authors.lastname: Pothuri
authors.affiliation: Division of Gynecologic Oncology,New York University Langone Medical Center,New York,New York.
authors.forename: John P
authors.initials: JP
authors.lastname: Curtin
authors.affiliation: Division of Gynecologic Oncology,New York University Langone Medical Center,New York,New York.
authors.forename: Stephanie V
authors.initials: SV
authors.lastname: Blank
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D055867:Cyclonic Storms; D004189:Disaster Planning; D004190:Disasters / Q000706:statistics & numerical data*; D005260:Female; D005833:Genital Neoplasms, Female / Q000628:therapy*; D006801:Humans; D008495:Medical Oncology / Q000458:organization & administration* / Q000706:statistics & numerical data; D008875:Middle Aged; D009519:New York City
keywords: delivery of health care; hurricane; natural disasters; patient transfer; quality of health care