Background: The Texas Gulf Coast was struck by Hurricane Ike in 2008 and Hurricane Harvey in 2017. While the public health impact of these events was widespread, little is known about their differential impact on patients scheduled for routine care encounters. Primary care resiliency is associated with better preventive care, which makes this important for healthcare systems to consider because of the increasing prevalence and severity of natural disasters.

Methods: Data were derived from the U.S. Department of Veterans Affairs (VA) Corporate Data Warehouse and included all appointments scheduled with VA primary care clinics for Houston and surrounding areas. The weekly percentage of missed primary care appointments (“resiliency”) for clinics in these areas was compared to others in the same administrative region, ranging from five weeks before to five weeks after the storms.

Results: For Hurricane Harvey, 14% of primary care appointments were kept the week of landfall (versus 33% for Ike), and 49% were kept the following week (versus 58% for Ike), suggesting a more widespread short-term impact on clinic operations relative to Ike. By the second week after both storms, the percentage of primary care appointments kept was approximately 60%. Unlike the more localized impact of Hurricane Ike, Hurricane Harvey impacted the resilience of clinics outside Houston, leading to lower appointment completion rates that were similar to the coastal regions.

Conclusions: Maintaining scheduled routine care reflects both within system preparedness and broader factors related to specific disasters, which influence measures of resilience and recovery.