Summary/Abstract
Climate change is intensifying extreme weather events. Yet a systematic analysis of post-disaster healthcare utilization and outcomes for severe weather and climate disasters, as tracked by the US government, is lacking. Tracking these outcomes is important for understanding the impact of climate-driven disasters on health, and for adaptation that protects patients and communities, health system resilience and policy.
This peer-reviewed study uses data from Medicare beneficiaries to examine changes in the rate of hospitalizations, emergency department visits, and mortality in the aftermath of disasters. Following exposure to 42 US billion-dollar weather disasters (severe storm, flood, flood/severe storm, tropical cyclone and winter storm) between 2011 and 2016, the authors used a difference-in-differences (DID) approach to quantify changes in the rates of emergency department visits, nonelective hospitalizations and mortality between fee-for-service Medicare beneficiaries in affected compared to matched control counties in post-disaster weeks 1, 1–2 and 3–6. Overall, disasters were associated with higher rates of emergency department use in affected counties in the first two weeks following a disaster (DID of 1.22% (95% CI, 0.20% to 2.25%; P < 0.020)). Nonelective hospitalizations were unchanged. Mortality was higher in affected counties in week 1 (DID of 1.40% (95% CI, 0.08% to 2.74%; P = 0.037)) and persisted for 6 weeks. Counties with the greatest loss and damage experienced greater increases in emergency department and mortality rates compared to all affected counties. Based on these observations, this study concludes that billion-dollar weather disasters are associated with excess emergency department visits and mortality in Medicare beneficiaries.