All-Cause Hospitalizations After Large-Scale Hurricanes Among Older Adults: A Self-Controlled Case Series Study

Introduction:Understanding the drivers of health care utilization patterns following disasters can better support health planning. This study characterized all-cause hospitalizations among older Americans after eight large-scale hurricanes.Study Objective:The objective of this study was to characterize all-cause hospitalizations for any cause among older Americans in the 30 days after eight large-scale hurricanes.Methods:A self-controlled case series study among Medicare beneficiaries (age 65+) exposed to one of eight hurricanes was conducted. The predicted probability of sociodemographic factors associated with hospitalization using logit models was estimated.Results:Hurricane Sandy (2012) had the highest post-hurricane admission rate, a 23% increase (incidence rate ratio [IRR] = 1.23; 95% CI, 1.22-1.24), while Hurricane Irene in 2011 had only a 10% increase (IRR = 1.10; 95% CI, 1.09-1.11). Higher likelihood of hospitalization occurring after hurricanes included being 85 or older (36.8% probability of hospitalization; 95% CI, 34.7-39.0) and being dually eligible for Medicare and Medicaid (62.8%; 95% CI, 60.7-64.9).Conclusion:Planning to address the surge in hospitalization for a longer time period after hurricanes and interventions targeted to support aging Americans are needed.