152684 A network approach to facilitating continuity of care for patients with chronic diseases in the aftermath of a natural disaster

Monday, November 5, 2007: 4:30 PM

Martha I. Arrieta, MD, MPH, PhD , USA Center for Healthy Communities, University of South Alabama, Mobile, AL
Nicole D. Guidry, BSW, MA , Mobile Exploreum, Mobile, AL
Tracey L. Henry, BS, MS, MSII , USA Center for Healthy Communities, University of South Alabama, Mobile, AL
Susan Y. Nelson, BA, MA , Georgia Perimeter College, Acworth, GA
Rachel D. Foreman, BS, MA , 720 Westview Drive SW, Morehouse School of Medicine, Atlanta, GA
Marjorie Icenogle, PhD , Department of Management, University of South Alabama, Mobile, AL
Errol D. Crook, MD , Department of Internal Medicine and Center for Healthy Communities, University of South Alabama, Mobile, AL
Background: Management of patients with chronic diseases (CD), requiring continuity of care and availability of medications, is disrupted post-disaster. Objectives: To document the experiences of primary care providers, hospitals, pharmacies, community-based organizations, and CD patients affected by Hurricane Katrina in order to identify 1) critical CD management needs after a disaster; 2) elements of a community-based network to meet those needs; and 2) resources required for a functional network. Methodology: Data gathered through 30 key informant interviews with administrators and providers of primary care centers, emergency rooms, pharmacies, and HIV/AIDS support organizations; and four focus groups with CD and HIV/AIDS patients. Advisory panel (AP) was convened—twelve key informants, one external member—to summarize challenges in post-disaster CD management and formulate recommendations. Data compiled from interviews, focus groups and one-day AP workshop, was circulated in report format among AP members for review. Report sections were discussed with the remaining 18 key informants as a member check. Results: Major challenges identified: pre-disaster patient education; communications (intra- and inter-organizational, patient—provider); transportation, fuel; lack of medical and prescription records; provision, storage and distribution of medications; special needs shelter capacity and staffing; mental health support (patients, staff); organization and coordination of donations and volunteers (health professionals, lay helpers). Recommendations included: network-facilitated disaster preparedness at the organization, local and regional levels; multi-level communications system including database of chronically ill patients, resource database, and capacity to back-up and share medical records; dissemination of emergency plan/resource guide with contact numbers and resource listings of all network partners.

Learning Objectives:
1. Identify barriers to chronic disease management in the wake of a natural disaster 2. Articulate the requirements of an effective community based network for continuity of chronic disease care in the face of disruptions of the primary care infrastructure 3. Identify elements of a plan to insure effective use of disaster relief resources to ensure continued management of chronic diseases through a disaster

Keywords: Disasters, Access and Services

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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