IMPORTANCE: Evacuation has been found to be associated with adverse outcomes among nursing home residents during hurricanes, but the outcomes for assisted living (AL) residents remain unknown. OBJECTIVE: To examine the association between evacuation and health care outcomes (ie, emergency department visits, hospitalizations, mortality, and nursing home visits) among Florida AL residents exposed to Hurricane Irma. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study using 2017 Medicare claims data. Participants were a cohort of Florida AL residents who were aged 65 years or older, enrolled in Medicare fee-for-service, and resided in 9-digit zip codes corresponding to US assisted living communities with 25 or more beds on September 10, 2017, the day of Hurricane Irma's landfall. Propensity score matching was used to match evacuated residents to those that sheltered-in-place based on resident and AL characteristics. Data were analyzed from September 2022 to February 2024. EXPOSURE: Whether the AL community evacuated or sheltered-in-place before Hurricane Irma made landfall. MAIN OUTCOMES AND MEASURES: Thirty- and 90-day emergency department visits, hospitalizations, mortality, and nursing home admissions. RESULTS: The study cohort included 25 130 Florida AL residents (mean [SD] age 81 [9] years); 3402 (13.5%) evacuated and 21 728 (86.5%) did not evacuate. The evacuated group had 2223 women (65.3%), and the group that sheltered-in-place had 14 556 women (67.0%). In the evacuated group, 42 residents (1.2%) were Black, 93 (2.7%) were Hispanic, and 3225 (94.8%) were White. In the group that sheltered in place, 490 residents (2.3%) were Black, 707 (3.3%) were Hispanic, and 20 212 (93.0%) were White. After 1:4 propensity score matching, when compared with sheltering-in-place, evacuation was associated with a 16% greater odds of emergency department visits (adjusted odds ratio [AOR], 1.16; 95% CI, 1.01-1.33; P = .04) and 51% greater odds of nursing home visits (AOR, 1.51; 95% CI, 1.14-2.00; P = .01) within 30 days of Hurricane Irma's landfall. Hospitalization and mortality did not vary significantly by evacuation status within 30 or 90 days after the landfall date. CONCLUSIONS AND RELEVANCE: In this cohort study of Florida AL residents, there was an increased risk of nursing home and emergency department visits within 30 days of Hurricane Irma's landfall among residents from communities that evacuated before the storm when compared with residents from communities that sheltered-in-place. The stress and disruption caused by evacuation may yield poorer immediate health outcomes after a major storm for AL residents. Therefore, the potential benefits and harms of evacuating vs sheltering-in-place must be carefully considered when developing emergency planning and response.
- MeSH
- cyklonové bouře * statistika a číselné údaje MeSH
- domy s pečovatelskou službou * statistika a číselné údaje MeSH
- hospitalizace statistika a číselné údaje MeSH
- lidé MeSH
- Medicare statistika a číselné údaje MeSH
- pečovatelské domovy statistika a číselné údaje MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- urgentní služby nemocnice statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
- Geografické názvy
- Florida MeSH
- Spojené státy americké MeSH
Práca je zameraná na špecifiká kvality života seniorov žijúcich v zariadeniach inštitucionálnej komunitnej starostlivosti. Súbor tvorilo 60 seniorov (30 žien, 30 mužov) vo veku 74,1 ± 5,7 rokov, z toho 30 seniorov žilo v penzióne a 30 seniorov v domove dôchodcov. Zisťovali sa rozdiely v kvalite života, pohode, zmysle života, postihnutí, veku, trvaní pobytu v zariadení, hodnotení zdravia, spokojnosti s bytovými podmienkami a celkovej spokojnosti v závislosti od typu starostlivosti a pohlavia. Kvalita života sa posudzovala PCASEE škálou, pohoda dotazníkom pohody, postihnutie škálou postihnutia, zmysel života LOGO testom, závislosť Barthelovym indexom. Hodnotenie zdravia, spokojnosť s bytovými podmienkami a celková spokojnosť sa hodnotili sebaposudzovacími stupnicami. Klienti domova dôchodcov mali signifikantne nižšiu kvalitu života, viac bio-psycho-sociálnych problémov, negatívnejšie hodnotili svoje zdravie a boli celkovo menej spokojní s pobytom v zariadení ako klienti penziónu dôchodcov. Muži boli viac postihnutí v rodine a domácnosti ako ženy. Metódy na sledovanie kvality života možno účinne uplatňovať v praxi pri identifikácii problémov a potrieb seniorov a pri indikovaní špecifických foriem starostlivosti.
The work is aimed at specific features of the quality of life of elderly people living in facilities of the institutional community care. The group included 60 persons (30 women, 30 men) of 74.1 ± 5.7 years of age. Of them, 30 persons lived in a boarding house and 30 persons lived in an old people house. Differences in the quality of their life, well-being, meaning of the life, type of involvement, gender, time of stay in the facility, evaluation of health condition, satisfaction with accommodation conditions and general satisfaction were determined depending on the type of care and gender. The quality of life was assessed by the PCASEE scale, the well-being by the well-being questionnaire, involvement by the involvement scale, meaning of life by the logo test, dependence by the Barthel index. The evaluation of the health, satisfaction with accommodation conditions and general satisfaction were considered based on the self-assessment scale. The clients of the old people home had a significantly lower quality of life, more bio-psycho-social problems, they evaluated their health conditions more negatively and they were less satisfied with the stay in the facility in comparison with clients of the boarding house for retired persons. The involvement in the family and household in men was larger than that in women. Thus, the method for following the quality of life can be effectively employed in practice in the identification of problems and needs of elderly people and in the indication of specific forms of the care.
