Analysis of the timing of evacuation and associated factors among home health care patients during flooding: A single-clinic-based mixed methods study

Abstract

Home health care patients (HHPs) are vulnerable to flooding and may face evacuation difficulties. Previous studies reported that HHPs and their families are more susceptible to disasters than non-HHPs. Our prior research revealed that many HHPs in Fukui, Japan, were at risk for flooding and landslides, requiring evacuation assistance, yet few were aware of the exact risks. This study analyzed survey data to identify barriers to evacuation during floods and assess the assistance needed among HHPs. A concurrent nested design of mixed-method research was employed. We calculated the percentage of the 87 HHPs at risk likely to delay evacuation and constructed univariable and multivariable logistic regression models to identify factors associated with delayed evacuation, and employed a thematic analysis to identify concerns and needs during evacuation. Family members responded to the questionnaire for patients unable to respond. The study found that 69.0 % of patients delayed evacuation, with 61.7 % incorrectly perceiving disaster risks and 20.0 % considering evacuation unimportant. Those with incorrect risk perceptions were slower to evacuate than those with accurate perceptions (OR: 1.35, 95 % confidence interval: 1.06–6.99, p-value: 0.036). Seven themes about flood preparedness needs were extracted from open-ended statements. Factors contributing to delayed evacuation included assumptions of vertical evacuation due to mobility challenges and concerns about evacuation site environments. Few Japanese HHPs at risk of flooding and landslides would plan an early evacuation, often due to misperceived disaster risks. Specific measures are needed to address these issues, and further investigation is required as flooding may also affect patient supporters.