Objective: The impact of natural disasters on medical utilization is largely unknown and often overlooked how it affects bereaving and non-bereaving survivors. The aim of this study is to determine the medical utilization between both survivor groups and long-term effects.
Study design: A 10-year 1999-2009 population-based retrospective study by using the National Health Insurance claim database and the Household Registration database from the Department of Health, Executive Yuan, Taiwan.
Settings: Taiwan 1999 Chi-Chi earthquake-affected areas.
Participants: A total of 49 834 individuals which included 1183 bereaving survivors and 48 651 non-bereaving earthquake survivors.
Main Outcome Measures: Medical utilization of bereaving and non-bereaving survivors.
Results: The results showed that bereaving survivors had significantly more outpatient visits before the earthquake, within 3-month period and 1 year after earthquake (odds ratio (OR) = 1.11, 1.16 and 1.08). However, after 1 year after earthquake their outpatient visits were not significantly different from non-bereaving, and even significantly less in some years. Inpatient visits of bereaving survivors had similar trend to outpatient visits, i.e. visits were more both before earthquake and within 3-month period after earthquake (OR = 1.59 and 1.89), however, they were not significantly higher than non-bereaving survivors for the following years of the study.
Conclusion: Our study reveals that compared to non-bereaving survivors, bereaving survivors slightly had higher medical utilization in the beginning stage of earthquake, i.e. for the first 3-month period or 1 year after earthquake. However, there were no differences between these two groups in medical utilization including outpatient and inpatient visits in long run.
- bereaving survivors
- health expenditure
- health risk
- medical utilization
- nature disasters
ASJC Scopus subject areas
- Health Policy
- Public Health, Environmental and Occupational Health