Hurricanes and healthcare: a case report on the influences of Hurricane Maria and managed Medicare in treating a Puerto Rican resident
| Autor: | David M. Abramson, George Mellgard, Himali Weerahandi, Charles Okamura |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Hurricane Maria Context (language use) Medicare 01 natural sciences Health informatics End stage renal disease Health administration Disasters 03 medical and health sciences 0302 clinical medicine Medical Tourism Renal Dialysis Case report Health care medicine Humans Multiple Chronic Conditions 030212 general & internal medicine 0101 mathematics Natural disaster Special enrollment period Refugees Insurance Health Cyclonic Storms business.industry lcsh:Public aspects of medicine Health Policy Public health Nursing research Puerto Rico 010102 general mathematics lcsh:RA1-1270 Hispanic or Latino Middle Aged Patient Acceptance of Health Care United States 3. Good health Managed Medicare Family medicine New York City business Delivery of Health Care |
| Zdroj: | BMC Health Services Research, Vol 19, Iss 1, Pp 1-5 (2019) BMC Health Services Research |
| ISSN: | 1472-6963 |
| DOI: | 10.1186/s12913-019-4630-z |
| Popis: | Background While Medicare is a federal health insurance program, managed Medicare limits access to healthcare services to networks within states or territories. However, if a natural disaster requires evacuation, displaced patients are at risk of losing coverage for their benefits. Previous literature has discussed the quality of managed Medicare plans within Puerto Rico but has not addressed the adequacy of this coverage if residents are displaced to the continental United States. We explore Hurricane Maria’s impact on a resident of Puerto Rico with chronic health problems, and the challenges he faces seeking healthcare in New York. Case presentation A 59-year-old male with a history of diabetes mellitus type II, coronary artery disease, peripheral vascular disease status post right foot amputation, and end-stage kidney disease on hemodialysis was admitted in October of 2017 for chest pain and swelling of legs for 5 days. The patient had missed his last three dialysis sessions after Hurricane Maria forced him to leave Puerto Rico. In examining this patient’s treatment, we observe the effect of Hurricane Maria on the medical management of Puerto Rican residents and identify challenges managed Medicare may pose to patients who cross state or territory lines. Conclusions We employ this patient’s narrative to frame a larger discussion of Puerto Rican managed Medicare and provide additional recommendations for healthcare providers. Moreover, we consider this case in the context of disaster-related continuity of care for patients with complex medical conditions or treatment regimens. To address the gaps in the care of these patients, this article proposes (1) developing system-based approaches for screening displaced patients, (2) increasing the awareness of Special Enrollment Periods related to Medicare among healthcare providers, and (3) creating policy solutions to assure access to care for patients with complex medical conditions. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink