Online Program

Hospital Readmissions Following Early Discharge in Anticipation of a Hospital Evacuation: Hurricane Sandy and the US Department of Veterans Affairs

Sunday, November 1, 2015

Aram Dobalian, PhD, MPH, JD, Veterans Emergency Management Evaluation Center (VEMEC), Veterans Health Administration, North Hills, CA
Anne Griffin, MPH, BSN, CNOR, Veterans Emergency Management Evaluation Center (VEMEC), Veterans Health Administration, North Hills, CA
Karen Chu, MS, Health Services Research & Development (HSR&D) Center of Excellence for the Study of Healthcare Provider Behavior, VA Greater Los Angeles Healthcare System (VAGLAHS), North Hills, CA
Anita Yuan, PhD, MPH, Health Services Research and Development Center, West Los Angeles VA Healthcare Center, Los Angeles, CA
Tamar Wyte-Lake, DPT, MPH, Veterans Emergency Management Evaluation Center (VEMEC), Veterans Health Administration, Sepulveda, CA
Introduction: Approximately 6,300 patients were evacuated from 37 healthcare facilities in New York City (NYC) because of “Superstorm Sandy.” Deciding whether to discharge patients early or evacuate them in anticipation of a disaster is challenging. During disasters, both hospitals that are evacuating patients and hospitals that anticipate receiving them typically utilize early discharge strategies to decrease the number of patients that must be evacuated and provide capacity to receive incoming patients. The impact of these early discharges on patient health is unclear.

Methods: We used data from the Department of Veterans Affairs (VA) to examine 30-day, all-cause hospital readmissions of patients who were discharged early from VA hospitals in NYC because of Hurricane Sandy.

Results: At Manhattan, 8 of 45 patients who were discharged on the day of the evacuation were readmitted to a VA hospital within 30 days. Similarly, at the receiving hospitals, 3 of 12 patients at Brooklyn and 2 of 9 patients at the Bronx were readmitted within 30 days of discharge. More than half of the readmitted patients were behavioral health patients.

Discussion & Conclusion: Early discharge instead of evacuation may result in hospital readmission, and places patients at increased risk of morbidity and mortality. Nevertheless, the reported readmission rates are similar to national and regional non-disaster readmission rates, suggesting that relatively safe care transitions during disasters may be feasible, at least in an integrated delivery system. Patients with significant behavioral health needs are at increased risk for readmission during a disaster.

Learning Areas:

Administration, management, leadership
Clinical medicine applied in public health
Provision of health care to the public
Public health or related public policy
Public health or related research

Learning Objectives:
Describe which patients are at greatest risk for readmission after evacuation from a hospital because of a disaster

Keyword(s): Disasters, Hospitals

Presenting author's disclosure statement:

Not Answered