Determinants of the evacuation destination for psychiatric hospital inpatients following the Fukushima nuclear disaster

Abstract

Psychiatric inpatients in the Fukushima prefecture were immediately evacuated from hospitals following the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident in 2011. Whereas the psychiatric status and physical condition of these patients have been considered as factors related to triage during hospital evacuation, few studies show how this background affects the evacuation destination. Thus, the study objective was to reveal associations between hospital evacuation destinations among psychiatric inpatients and their characteristics. This retrospective study enrolled psychiatric inpatients who had been evacuated by the Fukushima prefectural government following the FDNPP accident (N = 783). Patients were classified into two groups based on their evacuation destination (within/outside the Fukushima prefecture). Univariable and multivariable analyses were conducted to investigate the associations between evacuation destination and patients’ traits, including psychiatric/physical backgrounds. Three-quarters of inpatients were evacuated to hospitals outside the prefecture. Multivariable analysis showed that patients diagnosed with mental retardation (ICD-10 F70–79) and psychiatric patients with respiratory diseases (J00–99), genitourinary diseases (N00–99) as comorbidities tended to have been evacuated to hospitals within the prefecture. By contrast, patients with nervous system diseases (G00–99) as comorbidity tended to have been evacuated to hospitals outside the prefecture. In psychiatric patients, specific psychiatric diagnoses and several types of physical comorbidities were associated with the evacuation destination. Prospective follow-up studies are necessary to reveal how the presumed triage strategy has improved the outcomes in evacuated psychiatric patients.