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Maintaining Quality of Care among Dialysis Patients in Affected Areas after Typhoon Morakot

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  • Chia-Ming Chang

    (Department of Geriatrics & Gerontology, National Cheng Kung University Hospital, Tainan 70403, Taiwan
    School of Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan)

  • Tzu-Yuan Stessa Chao

    (Department of Urban Planning, National Cheng Kung University, Tainan 70101, Taiwan)

  • Yi-Ting Huang

    (School of Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
    Department of Urban Planning, National Cheng Kung University, Tainan 70101, Taiwan)

  • Yi-Fang Tu

    (School of Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
    Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan)

  • Tzu-Ching Sung

    (School of Medicine for International Students, I-Shou University, Kaohsiung 82445, Taiwan)

  • Jung-Der Wang

    (Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan)

  • Hsin-I Shih

    (School of Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
    Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
    Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan)

Abstract

Natural disasters have negative health impacts on patients who need dialysis in affected areas. Severely affected areas are usually rural, with limited basic infrastructure and a population without optimal dialysis-specific care after a disaster. A population-based longitudinal case–cohort study enrolled 715,244 adults from the National Health Insurance Registry who lived in areas affected by a major natural disaster, Typhoon Morakot, in 2009. The observation period was from 2008 to 2011. A total of 13,268 patients (1.85%) had a history of end-stage renal disease (ESRD). Of the ESRD patients, 1264 patients (9.5%) received regular dialysis. Only eight patients missed dialysis sessions in the first month after the disaster. Compared to the moderately affected areas, the incidences of acute cerebrovascular and cardiovascular diseases were higher in patients in severely affected areas. Male dialysis patients aged 45–75 years had a higher mortality rate than that of the general population. Among the affected adults receiving regular dialysis, patients with diabetes (adjusted hazard ratio (aHR): 1.58, 95% confidence interval (CI): 1.20–2.08) or a history of cerebrovascular disease (aHR: 1.58, 95% CI: 1.12–2.21), chronic obstructive pulmonary disease (COPD) or asthma (aHR: 1.99, 95% CI: 1.24–3.17) in moderately affected areas had significantly elevated mortality rates. Additionally, among dialysis patients living in severely affected areas, those with a history of cerebrovascular disease (aHR: 4.52 95% CI: 2.28–8.79) had an elevated mortality rate. Early evacuation plans and high-quality, accessible care for cardiovascular and cerebrovascular diseases are essential to support affected populations before and after disasters to improve dialysis patients’ health outcomes.

Suggested Citation

  • Chia-Ming Chang & Tzu-Yuan Stessa Chao & Yi-Ting Huang & Yi-Fang Tu & Tzu-Ching Sung & Jung-Der Wang & Hsin-I Shih, 2021. "Maintaining Quality of Care among Dialysis Patients in Affected Areas after Typhoon Morakot," IJERPH, MDPI, vol. 18(14), pages 1-13, July.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:14:p:7400-:d:592231
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    References listed on IDEAS

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    1. Hsin-I Shih & Tzu-Yuan Chao & Yi-Ting Huang & Yi-Fang Tu & Tzu-Ching Sung & Jung-Der Wang & Chia-Ming Chang, 2020. "Increased Medical Visits and Mortality among Adults with Cardiovascular Diseases in Severely Affected Areas after Typhoon Morakot," IJERPH, MDPI, vol. 17(18), pages 1-16, September.
    2. Likwang Chen & Winnie Yip & Ming‐Cheng Chang & Hui‐Sheng Lin & Shyh‐Dye Lee & Ya‐Ling Chiu & Yu‐Hsuan Lin, 2007. "The effects of Taiwan's National Health Insurance on access and health status of the elderly," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 223-242, March.
    3. Plough, A. & Fielding, J.E. & Chandra, A. & Williams, M. & Eisenman, D. & Wells, K.B. & Law, G.Y. & Fogleman, S. & Magaña, A., 2013. "Building community disaster resilience: Perspectives from a large urban county department of public health," American Journal of Public Health, American Public Health Association, vol. 103(7), pages 1190-1197.
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