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Chief Complaints, Diagnoses, and Medications Prescribed Seven Weeks Post-Katrina in New Orleans

Published online by Cambridge University Press:  28 June 2012

Erica Howe ,
David Victor  and
Eboni G. Price
Erica Howe
Affiliation:
Department of Medicine, Tulane University Health Sciences Center, New Orleans, Louisiana, USA
David Victor
Affiliation:
Department of Medicine, Tulane University Health Sciences Center, New Orleans, Louisiana, USA
Eboni G. Price*
Affiliation:
Department of Medicine, Tulane University Health Sciences Center, New Orleans, Louisiana, USA
*
Associate Program Director, Internal Medicine Residency Program Tulane University Health Sciences Center 1430 Tulane Avenue, SL-16 New Orleans, Louisiana 70112 USA E-mail: eprice@tulane.edu
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Abstract

Background:

In the aftermath of Hurricane Katrina, widespread flooding devastated the New Orleans healthcare system. Prior studies of post-hurri-cane healthcare do not consistently offer evidence-based recommendations for re-establishing patient care post-disaster. The primary objective of this study is to examine associations between patient characteristics, chief com-plaints, final diagnoses, and medications prescribed at a post-Katrina clinic to better inform strategic planning for post-disaster healthcare delivery (e.g., charitable donations of medications and medical supplies).

Methods:

This study is a retrospective chart review of 465 patient visits from 02 September 2005 to 22 October 2005 at a post-Katrina clinic in New Orleans, Louisiana that was open for seven weeks, providing urgent care services in the central business district. Using logistic regression, the relationships between patient characteristics (date of visit, gender, age, evacuation status), type of chief complaint, final diagnosis, and type of medication prescribed was examined.

Results:

Of 465 patients, 49.2% were middle-aged, 62.4% were men, 35% were relief workers, and 33.3% were evacuees; 35% of visits occurred in week five. Of 580 chief complaints, 71% were illnesses, 21% were medication refill requests, and 8.5% were injuries. Among 410 illness complaints, 25% were ears, nose, and throat (ENT)/dental, 17% were dermatologic, and 11% were cardiovascular. Most requested classes of medication refills for chronic medical conditions (n = 121) were cardiovascular (52%) and endocrine (24%).Most illness-related diagnoses (n = 400) were ENT/dental (18.2%), dermatologic (14.8%), cardiovascular (10.2%), and pul-monary (10.2%). Thirty-six percent of these diagnoses were infectious. Among 667 medications prescribed, 21% were cardiac agents, 13% pulmonary, 13% neurologic/musculoskeletal/pain, 11% antibiotics, 10% endocrine, and 9.3% anti-allergy. The likelihood of certain chief complaints, diagnoses, and medica-tions prescribed varied with patient characteristics.

Conclusions:

Donations of certain classes of medications were more useful than others. Prevalence of select co-morbidities, the nature of patient involve-ment in recovery activities in the disaster area, and post-disaster health haz-ards may explain variations in chief complaints, diagnoses, and medications prescribed by patient characteristics.

Keywords

chief complaintcomplaintsdemographydiagnosisfloodHurricane KatrinamedicationsNew Orleans
Type
Research Article
Information
Prehospital and Disaster Medicine , Volume 23 , Issue 1 , February 2008 , pp. 41 - 47
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2008

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