Short-term Effect of Hurricane Sandy on Diabetes Related Hospitalizations in New Jersey

Introduction

This study examines the impact of Hurricane Sandy (HS) on preventable hospitalizations for complications of diabetes (DM). Such hospitalizations result from inappropriate or interrupted ambulatory care.  

Methods

Hospitalizations for DM complications were obtained from the NJ Hospital Discharge Data Collection System (NJDDCS).  Sandy period was defined as October 28-December 28, 2012. The pre-HS period was defined as December 29, 2011– October 27, 2012.  To assess the effect of seasonality, Sandy period hospitalization rates were compared to pre-HS rates in 2012 and in 2008-2011 combined. Municipalities where > 40% of households were poor or asset constrained were classified as low socioeconomic status (SES).  Associations between rates, years and SES, by Sandy period were tested using Poisson regression.

Results

There were 6,124 (5.8/100,000) hospitalizations for DM complications in 2012.  Significantly higher rates occurred during the Sandy period, 6.2 vs. 5.7/100,000 for the pre-HS period (p=0.03).  In contrast, for 2008-2011 combined, there was no difference in average hospitalizations for the pre-HS and Sandy periods.  Lower SES communities had significantly higher rates than higher SES communities (8.4 vs. 4.0/100,000 in 2012 p≤0.0001).  Both lower and higher SES communities increased from pre-Sandy to Sandy months (Low: 8.3 to 8.9/100,000; High: 3.9 to 4.2 per 100,000).

Conclusions

HS resulted in an increase of preventable hospitalizations for DM complications in NJ, affecting communities in the lower and higher SES.

Implications

Major events like hurricanes can impact rates of preventable hospitalizations that might have been averted through outpatient care received in an ambulatory care setting.