Association of Power Outage With Mortality and Hospitalizations Among Florida Nursing Home Residents After Hurricane Irma

Autor: Julianne Skarha, Ross Andel, David Dosa, Joseph June, Dylan J. Jester, Lindsay J. Peterson, Nazmus Sakib, Lily K. Gordon
Rok vydání: 2021
Předmět:
Zdroj: JAMA Health Forum
ISSN: 2689-0186
DOI: 10.1001/jamahealthforum.2021.3900
Popis: Key Points Question What is the association of a power outage after a hurricane with hospitalization and mortality among nursing home residents? Findings In this retrospective cohort study of 54 095 nursing home residents in Florida, more than half of residents experienced power loss when Hurricane Irma landed in 2017. Power loss was associated with an increased odds of mortality within 7 days and 30 days after the storm. Meaning The study results suggest that further research should assess the benefits and costs of policies that require nursing homes to have emergency alternate power sources.
Importance Exposure to hurricanes is associated with increased mortality and morbidity in nursing home (NH) residents, but the factors contributing to these outcomes are less understood. One hypothesized pathway could be power outages from hurricanes that expose NH residents to excess ambient heat. Objective To determine the association of power loss from Hurricane Irma with hospitalization and mortality in NH residents in Florida. Design, Setting, and Participants This retrospective cohort study of NH residents residing in Florida when Hurricane Irma landed on September 10, 2017, assessed mortality at 7 and 30 days after the storm and hospitalization at 30 days after the storm. The analysis was conducted from May 2, 2021, to June 28, 2021. All NH residents residing in Florida at landfall were eligible (N = 67 273). We excluded those younger than 65 years, missing power status information, or who were evacuated (13 178 [19.6%]). Exposure We used state-administered surveys to determine NH power outage status. Exposed residents experienced a power outage poststorm, whereas unexposed residents did not experience a power outage poststorm. Main Outcomes and Measures We used Medicare claims to assess mortality and hospitalization after Hurricane Irma landfall using generalized linear models with robust standard errors. Results In the aftermath of Hurricane Irma, 27 892 residents (18 510 women [66.4%]; 3906 [14.0%] Black, 1651 [5.9%] Hispanic, and 21 756 [78.0%] White individuals) in 299 NHs were exposed to power loss and 26 203 residents (17 620 women [67.2%]; 4175 [15.9%] Black, 1030 [3.9%] Hispanic, and 20 477 [78.1%] White individuals) in 292 NHs were unexposed. Nursing homes that lost power were similar in size, quality star rating, and type of ownership compared with NHs that did not lose power. Power loss was associated with an increased adjusted odds of mortality among all residents within 7 days (odds ratio [OR],1.25; 95% CI,1.05-1.48) and 30 days (OR, 1.12; 95% CI,1.02-1.23) poststorm and hospitalization within 30 days, although only among residents aged 65 to 74 years (OR, 1.16; 95% CI, 1.03-1.33). Conclusions and Relevance In this cohort study, power loss was associated with higher odds of mortality in all affected NH residents and hospitalization in some residents. The benefits and costs of policies that require NHs to have emergency alternate power sources should be assessed.
This cohort study examines the association of power loss from Hurricane Irma with hospitalization and mortality in nursing home residents in Florida.
Databáze: OpenAIRE
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