Disasters and Hospital Systems Serving Populations That Experience Health Disparities: Identifying the Long Term effects of Pandemics and Disasters in Order to Mitigate Future Challenges

Brigham And Women'S Hospital, Boston MA

Investigators

Abstract

Hospital Systems Serving Health Disparity Populations (HSSHDPs) deliver needed services to racial and ethnic minority groups and other communities. HSSHDPs may experience long-term effects of natural and man-made disasters that in turn could affect health outcomes. Using the framework of the disaster management cycle (mitigation, preparedness, response, and recovery), this project proposes to conduct a mixed methods study of the long-term effects of pandemics on US hospitals across four critical domains (quality, workforce, finances, and innovation), with a special focus on HSSHDPs and on the health disparity populations they serve. This project will be the first major national investigation of the effects of national disasters on HSSHDPs. This rigorous mixed methods study will be significant in identifying HSSDHPS most and least affected by pandemics and will deepen the understanding of the contributing factors that led to successes and challenges. The study will identify actionable best practices and challenges to HSSHDPs’ operations before, during and after pandemics. The specific aims of this study are: Aim 1. Describe the long-term effects of pandemics on hospitals and the perceived usefulness of disaster management planning activities (including interactions with Coalitions). In partnership with the American Hospital Association and America’s Essential Hospitals a nationally representative survey of 2000 hospitals will be conducted to examine variation by HSSHDP status and other characteristics. Aim 2. Analyze changes over time (2018-2024) in hospital-level quality, service levels, and finances, and in patient-level outcomes. Using secondary data sources, the study will focus on differences among HSSHDPs and non-HSSHDPs. Aim 3. Explore the innovations undertaken by HSSHDPs to mitigate the effects of pandemics. The study will include 10 in-depth case studies, using purposive sampling to select HSSHDPs and non-HSSHDPs. Semi-structured interviews with stakeholders will be used to more fully understand existing structures, challenges, interactions with Coalitions, and other disaster management strategies. Aim 4. Develop prioritized policy recommendations to enhance resilience of our most critical public health systems for future disasters. A national Delphi consensus panel in conjunction with the National Academy of Science Engineering and Medicine will be conducted.