Providing Continuity of Care for Chronic Diseases in the Aftermath of Katrina: From Field Experience to Policy Recommendations

被引:64
作者
Arrieta, Martha I. [1 ,2 ]
Foreman, Rachel D. [1 ,2 ]
Crook, Errol D. [1 ,2 ]
Icenogle, Marjorie L. [3 ]
机构
[1] Univ S Alabama, Ctr Healthy Communities, Mobile, AL 36688 USA
[2] Univ S Alabama, Dept Internal Med, Mobile, AL 36688 USA
[3] Univ S Alabama, Mitchell Coll Business, Mobile, AL 36688 USA
关键词
HURRICANE-KATRINA; MEDICAL-CARE; HEALTH-CARE; NEW-ORLEANS; PREPAREDNESS; EVACUEES; DISASTER; STRESS; NEEDS; RITA;
D O I
10.1097/DMP.0b013e3181b66ae4
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
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. (Disaster Med Public Health Preparedness. 2009; 3: 174-182)
引用
收藏
页码:174 / 182
页数:9
相关论文
共 42 条
[1]  
[Anonymous], 1992, EMERGENCE VS FORCING
[2]   Left behind: the legacy of hurricane Katrina [J].
Atkins, D ;
Moy, EM .
BRITISH MEDICAL JOURNAL, 2005, 331 (7522) :916-918
[3]  
*ATL SCI SOFTW DEV, 2006, ATL IT COMP PROGR VE
[4]   Integrating hospitals into community emergency preparedness planning [J].
Braun, Barbara I. ;
Wineman, Nicole V. ;
Finn, Nicole L. ;
Barbera, Joseph A. ;
Schmaltz, Stephen P. ;
Loeb, Jerod M. .
ANNALS OF INTERNAL MEDICINE, 2006, 144 (11) :799-811
[5]  
BREWIN B, DIASPORA DISPATCHES
[6]   Experiences of Hurricane Katrina evacuees in Houston shelters: Implications for future planning [J].
Brodie, Mollyann ;
Weltzien, Erin ;
Altman, Drew ;
Blendon, Robert J. ;
Benson, John M. .
AMERICAN JOURNAL OF PUBLIC HEALTH, 2006, 96 (08) :1402-1408
[7]  
Brown Steven H, 2007, Am J Public Health, V97 Suppl 1, pS136, DOI 10.2105/AJPH.2006.104943
[8]   Infoglut [J].
Denning, Peter J. .
COMMUNICATIONS OF THE ACM, 2006, 49 (07) :15-19
[9]   Creating a more resilient safety net for persons with chronic disease: Beyond the "Medical home" [J].
DeSalvo, Karen B. ;
Kertesz, Stefan .
JOURNAL OF GENERAL INTERNAL MEDICINE, 2007, 22 (09) :1377-1379
[10]   Symptoms of posttraumatic stress disorder in a New Orleans workforce following Hurricane Katrina [J].
DeSalvo, Karen B. ;
Hyre, Amanda D. ;
Ompad, Danielle C. ;
Menke, Andy ;
Tynes, L. Lee ;
Muntner, Paul .
JOURNAL OF URBAN HEALTH-BULLETIN OF THE NEW YORK ACADEMY OF MEDICINE, 2007, 84 (02) :142-152