Patient-Focused Disaster Preparedness| Volume 336, ISSUE 2, P128-133, August 2008

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Insuring Continuity of Care for Chronic Disease Patients After a Disaster: Key Preparedness Elements



      Care for patients with chronic diseases is a challenge after a disaster. This is particularly true for individuals from health disparate populations as they are less likely to evacuate, have fewer financial resources and often depend on resource-strapped institutions for their care. The specific aim of the study presented here was to elicit challenges and solutions in the provision of health care to those with chronic diseases after Hurricane Katrina in coastal Alabama and Mississippi.


      Focusing on agencies providing care to health disparate populations, a qualitative methodology was employed using in-depth interviews with health and social service providers. Participants identified key elements essential to disaster preparedness.


      Predisaster issues were patient education and preparedness, evacuation, special needs shelters, and health care provider preparedness. Postdisaster issues were communication, volunteer coordination, and donation management.


      Lessons learned from those on the ground administering health care during disasters should inform future disaster preparations. Furthermore, the methodological approach used in this study engendered collaboration between health care institutions and may enhance future interagency disaster preparedness.


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        • Hick J.L.
        • Hanfling D.
        • Burstein J.L.
        • et al.
        Health care facility and community strategies for patient care surge capacity.
        Ann Emerg Med. 2004; 44: 253-261
        • Kutner N.G.
        Health needs, health care, and Katrina.
        in: Brunsma D.L. Overfelt D. Picou J.S. The sociology of Katrina: perspectives on a modern catastrophe. Rowman & Littlefield Publishers, Inc, Lanham (MD)2007: 203-215
        • Stephens K.U.
        • Grew D.
        • Chin K.
        • et al.
        Excess mortality in the aftermath of hurricane Katrina: a preliminary report.
        Disaster Med Public Health Preparedness. 2007; 1: 15-20
        • Madamala K.
        • Campbell C.R.
        • Hsu E.B.
        • et al.
        Characteristics of physician relocation following Hurricane Katrina.
        Disaster Med Public Health Preparedness. 2007; 1: 21-26
        • Millin M.G.
        • Jenkins J.L.
        • Kirsch T.
        A comparative analysis of two external health care disaster responses following Hurricane Katrina.
        Prehosp Emerg Care. 2006; 10: 451-456
        • Brodie M.
        • Weltzien E.
        • Altman D.
        • et al.
        Experiences of hurricane Katrina evacuees in Houston shelters: Implications for future planning.
        Am J Public Health. 2006; 96: 1402-1408
        • Edwards T.D.
        • Young R.A.
        • Lowe A.F.
        Caring for a surge of hurricane Katrina evacuees in primary care clinics.
        Ann Fam Med. 2007; 5: 170-174
        • Ford E.S.
        • Mokdad A.H.
        • Link M.W.
        • et al.
        Chronic disease in health emergencies: in the eye of the hurricane.
        Prev Chronic Dis. 2006; 3: 1-8
        • Gavagan T.
        • Smart K.
        • Palacio H.
        • et al.
        Hurricane Katrina: medical response at the Houston Astrodome/Reliant center complex.
        South Med J. 2006; 99: 933-939
        • Ghosh T.S.
        • Patnaik J.L.
        • Vogt R.L.
        Rapid needs assessment among Hurricane Katrina evacuees in metro-Denver.
        J Health Care Poor Underserved. 2007; 18: 362-368
        • Ridenour M.L.
        • Cummings K.J.
        • Sinclair J.R.
        • et al.
        Displacement of the underserved: Medical needs of Hurricane Katrina evacuees in West Virginia.
        J Health Care Poor Underserved. 2007; 18: 369-381
        • Vest J.R.
        • Valadez A.M.
        Health conditions and risk factors of sheltered persons displaced by Hurricane Katrina.
        Prehospital Disaster Med. 2006; 21: 55-58
        • CDC
        Morbidity surveillance after Hurricane Katrina–Arkansas, Louisiana, Mississippi, and Texas, September 2005.
        MMWR-Morb Mortal Wkly Rep. 2006; 55: 727-731
        • CDC
        Illness surveillance and rapid needs assessment among Hurricane Katrina evacuees–Colorado, September 1–23, 2005.
        MMWR-Morb Mortal Wkly Rep. 2006; 55: 244-247
        • Coker A.L.
        • Hanks J.S.
        • Eggleston K.S.
        • et al.
        Social and mental health needs assessment of Katrina evacuees.
        Disaster Manage Response. 2006; 4: 88-94
        • Larrance R.
        • Anastario M.
        • Lawry L.
        Health status among internally displaced persons in Louisiana and Mississippi travel trailer parks.
        Ann Emerg Med. 2007; 49 (601 e591-e512): 590-601
        • Rodriguez H.
        • Aguirre B.E.
        Hurricane Katrina and the healthcare infrastructure: a focus on disaster preparedness, response, and resiliency.
        Front Health Serv Manage Fall. 2006; 23 (discussion 25-30): 13-23
        • Rosenbaum S.
        US health policy in the aftermath of Hurricane Katrina.
        JAMA. 2006; 295: 437-440
        • Ursano R.J.
        • Cerise F.P.
        • DeMartino R.
        • et al.
        The impact of disasters and their aftermath on mental health.
        J Clin Psychiatry. 2006; 67: 7-14
        • Weisler R.H.
        • Barbee IV, J.G.
        • Townsend M.H.
        Mental health and recovery in the gulf coast after hurricanes Katrina and Rita.
        JAMA. 2006; 296: 585-588
        • Proser M.
        • Shin P.
        • Hawkins D.
        A nation’s health at risk III.
        Growing uninsured, budget cutbacks challenge president’s initiative to put a health center in every poor county: National Association of Community Health Centers and The George Washington University. 2005
        • Dawsey J.
        • Campbell D.
        • Cyr K.
        Rebuilding a community health center following a natural disaster: interview in Biloxi, Mississippi. Interview by Tom Bearden.
        Health Aff (Millwood). 2007; 26: w644-w650
        • NACHC
        Legacy of a disaster: Health centers and hurricane Katrina one year later.
        National Association of Community Health Centers Web Site. 2007 (Available at, Accessed June 20)
        • Clawson A.
        • Menachemi N.
        • Beitsch L.
        • et al.
        Are community health centers prepared for bioterrorism?.
        Biosecur Bioterror. 2006; 4: 55-63
        • Katz A.
        • Staiti A.B.
        • McKenzie K.L.
        Preparing for the unknown, responding to the known: Communities and public health preparedness.
        Health Aff (Millwood). 2006; 25: 946-957
        • Arrieta M.
        • Foreman R.
        • Crook E.
        • et al.
        A network approach to facilitating continuity of care for patients with chronic diseases in the aftermath of a natural disaster. Center for Healthy Communities Research Office, University of South Alabama, Mobile (AL)2007
      1. Atlas.ti Scientific Software Development GMBH [computer program]. Version 5.2.9. 2006 (Berlin, Germany)
        • OCEMA
        Guidelines for special medical needs shelters. 2007 (Oconee County (South Caroline) Emergency Management Agency Web Site. Available at, Accessed June 21)