Restoration of medical oncology services at Charity Hospital in New Orleans after Hurricane Katrina: A 2-year experience of the Louisiana State University Health Sciences Center (LSUHSC).

Abstract

6025 Background: Oncology services at Charity Hospital were discontinued following Hurricane Katrina in August 2005. Displaced, uninsured and underinsured patients received cancer care throughout the United States in an ad hoc manner following the storm. Medical oncology and chemotherapy services resumed September 1, 2007; on-site radiation oncology remains unavailable. Demographic, clinical and displacement data of the re-established patient cohort were reviewed. Methods: We identified patients evaluated in the LSUHSC Oncology Clinics from September 1, 2007 to August 31, 2009. Data collected included: time from diagnosis of malignancy to initial oncology evaluation, insurance status, percentage displaced for 6 months or more due to Hurricane Katrina, ethnicity, referrals for radiation oncology and number outpatient clinical encounters (OCE) pre- and post-Hurricane Katrina. Results: 464 patients were evaluated in the study time period. 65% of patients had new cancer diagnoses and 35% re-established cancer care in the charity system. Mean time from new diagnosis to initial oncology evaluation was 59 days. 44% were insured by Medicaid, 13% by Medicare, 43% had no medical insurance. 34% were confirmed to be displaced for greater than six months. 62% were African- American and 25% Caucasian. 30% were referred to outside facilities for radiation oncology reimbursed by Medicaid or Charity Hospital. For fiscal years 2004 and 2005, there were 4468 OCE and 3348 OCE, respectively. There were 2439 OCE from 2007 to 2009, representing a 70% decline in patient volume following Hurricane Katrina. Conclusions: Oncology services for a minority-based, underinsured patient population were severely impacted by Hurricane Katrina. Following the storm, persistent system-wide resource limitations led to suboptimal timeliness of medical oncology evaluations. Health care systems serving underinsured patients require a disaster plan to minimize interruption of oncology care. Our experience illustrates the need for resources to ensure rapid re-establishment of care for economically disadvantaged patients following natural disasters. No significant financial relationships to disclose.