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10.1097/SMJ.0b013e31827c5a0c

http://scihub22266oqcxt.onion/10.1097/SMJ.0b013e31827c5a0c
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C5340286!5340286!23263319
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suck abstract from ncbi


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pmid23263319      South+Med+J 2013 ; 106 (1): 82-8
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  • Using Appendiceal Perforation Rates to Measure Impact of a Disaster on Healthcare System Effectiveness #MMPMID23263319
  • Mack D; Rust GS; Baltrus P; Moore B; Sow C; Patel V; Thomas D
  • South Med J 2013[Jan]; 106 (1): 82-8 PMID23263319show ga
  • Objectives: To understand baseline inequities in appendiceal perforation rates and the impact of hurricane destruction on the healthcare system with respect to perforation rates and racial disparities. Methods: We used claims data extracted from Medicaid Analytic Extract files to identify appendicitis diagnoses in children and adolescents based on International Classification of Diseases-9 codes and appendectomy procedures based on Current Procedural Terminology codes in the hurricane-affected states of Mississippi and Louisiana. County-level summary data obtained from 2005 Area Resource Files were used to determine high and low hurricane-affected areas. We estimated logistic regression models, mutually adjusting for race, sex, and age, to examine disparities and mixed logistic regression models to determine whether county-level effects contributed to perforation rates. Results: There were nine counties in the high-impact area and 133 counties in the low-impact area. Living in the high- or low-impact area was not associated with a statistically different rate of perforation before or after Hurricane Katrina; however, living in the high-impact area was associated with a change from a lower risk (odds ratio [OR] 0.62) of perforation prehurricane to a higher risk (OR 1.14) posthurricane compared with those living in the low-impact areas. African Americans had statistically higher perforation rates than whites in the high-impact areas both before (OR 1.46) and after (OR 1.71) Hurricane Katrina. Conclusions: Health professionals and hospital systems were able to maintain effective levels of care before and after Hurricane Katrina; however, perforation rates in African Americans suggest ongoing racial disparities during disasters.
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