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{
    "pk": 10784,
    "title": "Impact of Superstorm Sandy on Medicare Patients’ Utilization of Hospitals and Emergency Departments",
    "subtitle": null,
    "abstract": "Introduction: National health security requires that healthcare facilities be prepared to provide rapid,effective emergency and trauma care to all patients affected by a catastrophic event. We sought toquantify changes in healthcare utilization patterns for an at-risk Medicare population before, during,and after Superstorm Sandy’s 2012 landfall in New Jersey (NJ).\nMethods: This study is a retrospective cohort study of Medicare beneficiaries impacted bySuperstorm Sandy. We compared hospital emergency department (ED) and healthcare facilityinpatient utilization in the weeks before and after Superstorm Sandy landfall using a 20%random sample of Medicare fee-for-service beneficiaries continuously enrolled in 2011 and 2012(N=224,116). Outcome measures were pre-storm discharges (or transfers), average length of stay,service intensity weight, and post-storm ED visits resulting in either discharge or hospital admission.\nResults: In the pre-storm week, hospital transfers from skilled nursing facilities (SNF) increased by39% and inpatient discharges had a 0.3 day decreased mean length of stay compared to the prioryear. In the post-storm week, ED visits increased by 14% statewide; of these additional “surge”patients, 20% were admitted to the hospital. The increase in ED demand was more than double thestatewide average in the most highly impacted coastal regions (35% versus 14%).\nConclusion: Superstorm Sandy impacted both pre- and post-storm patient movement in NewJersey; post-landfall ED surge was associated with overall storm impact, which was greatest incoastal counties. A significant increase in the number and severity of pre-storm transfer patients,in particular from SNF, as well as in post-storm ED visits and inpatient admissions, draws attentionto the importance of collaborative regional approaches to healthcare in large-scale events.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Health Care Preparedness"
        },
        {
            "word": "Public Health Emergencies"
        },
        {
            "word": "Medical Surge"
        },
        {
            "word": "Surge Capacity"
        },
        {
            "word": "Medicare"
        }
    ],
    "section": "Emergency Department Access",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/8t61v46p",
    "frozenauthors": [
        {
            "first_name": "Benoit",
            "middle_name": "",
            "last_name": "Stryckman",
            "name_suffix": "",
            "institution": "U.S. Department of Health and Human Services, Washington, D.C.",
            "department": "None"
        },
        {
            "first_name": "Lauren",
            "middle_name": "",
            "last_name": "Walsh",
            "name_suffix": "",
            "institution": "U.S. Department of Health and Human Services, Washington, D.C.",
            "department": "None"
        },
        {
            "first_name": "Brendan",
            "middle_name": "",
            "last_name": "Carr",
            "name_suffix": "",
            "institution": "U.S. Department of Health and Human Services, Washington, D.C.\nThomas Jefferson University, Department of Emergency Medicine, Philadelphia, Pennsylvania",
            "department": "None"
        },
        {
            "first_name": "Nathaniel",
            "middle_name": "",
            "last_name": "Hupert",
            "name_suffix": "",
            "institution": "U.S. Department of Health and Human Services, Washington, D.C.\nWeill Cornell Medical College, Department of Healthcare Policy and Research, Department of Medicine, New York, New York",
            "department": "None"
        },
        {
            "first_name": "Nicole",
            "middle_name": "",
            "last_name": "Lurie",
            "name_suffix": "",
            "institution": "U.S. Department of Health and Human Services, Washington, D.C.",
            "department": "None"
        }
    ],
    "date_submitted": "2017-05-01T17:26:57Z",
    "date_accepted": "2017-05-01T17:26:57Z",
    "date_published": "2017-09-21T07:00:00Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/10784/galley/5874/download/"
        }
    ]
}