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Hospitalization Rates Among Dialysis Patients During Hurricane Katrina

  • David Howard (a1), Rebecca Zhang (a2), Yijian Huang (a2) and Nancy Kutner (a3)
Abstract
AbstractIntroduction

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.

Problem

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.

Howard D, Zhang R, Huang Y, Kutner N. Hospitalization rates among dialysis patients during Hurricane Katrina. Prehosp Disaster Med. 2012;27(4):1-5.

Copyright
Corresponding author
Correspondence: David Howard, PhD Department of Health Policy and Management Emory University 1518 Clifton Road NE Atlanta, GA 30322 USA E-mail david.howard@emory.edu
Linked references
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This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1. RJZ Kenney . Emergency preparedness concepts for dialysis facilities: reawakened after Hurricane Katrina. Clin J Am Soc Nephrol. 2007;2(4):809-813.

2. MA Kleinpeter , LD Norman , NK Krane . Dialysis services in the hurricane-affected areas in 2005: lessons learned. Am J Med Sci. 2006;332(5):259-263.

3. AH Anderson , AJ Cohen , NG Kutner , JB Kopp , PL Kimmel , P Muntner . Missed dialysis sessions and hospitalization in hemodialysis patients after Hurricane Katrina. Kidney Int. 2009;75(11):1202-1208.

4. AD Hyre , AJ Cohen , NG Kutner , . Psychosocial status of hemodialysis patients one year after Hurricane Katrina. Am J Med Sci. 2008;336(2):94-98.

6. NG Kutner , P Muntner , Y Huang , . Effect of Hurricane Katrina on the mortality of dialysis patients. Kidney Int. 2009;76(7):760-766.

7. JB Kopp , LK Ball , A Cohen , . Kidney patient care in disasters: lessons from the hurricanes and earthquake of 2005. Clin J Am Soc Nephrol. 2007;2(4):814-824.

9. AR Sehgal . Outcomes of renal replacement therapy among blacks and women. Am J Kid Dis. 2000;35(4 Suppl 1):S148-S152.

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Prehospital and Disaster Medicine
  • ISSN: 1049-023X
  • EISSN: 1945-1938
  • URL: /core/journals/prehospital-and-disaster-medicine
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