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期刊来源：Nat Med

原文链接：https://doi.org/10.1038/s41591-024-02833-x

摘要内容如下：

气候变化正在加剧极端天气事件。然而，正如美国政府所追踪的那样，缺乏对灾后医疗利用和严重天气和气候灾害后果的系统分析。在2011年至2016年期间遭受420亿美元的天气灾害（强风暴、洪水、洪水/强风暴、热带气旋和冬季风暴）后，我们使用双重差分（DID）方法来量化灾后第1周、第1-2周和第3-6周受影响县与匹配对照县的按服务收费的医疗保险受益人之间的急诊科（ED）就诊率、非选择性住院率和死亡率的变化。总体而言，在灾后第1周，灾害与受影响县较高的急诊使用率相关（DID为1.22%（95%CI，0.20%至2.25%；P<0.020））直到第2周。非选择性住院治疗没有变化。在第1周，受影响县的死亡率较高（DID为1.40%（95%CI，0.08%至2.74%；P=0.037）），并持续6周。与所有受影响的县相比，损失和损害最大的县经历了更大的ED和死亡率增加。因此，数十亿美元的天气灾害与过多的急诊就诊和医疗保险受益人的死亡率有关。跟踪这些结果对于保护患者和社区、卫生系统复原力和政策的适应非常重要。

英文原文如下：

Abstracts

Climate change is intensifying extreme weather events. Yet a systematic analysis of post-disaster healthcare utilization and outcomes for severe weather and climate disasters, as tracked by the US government, is lacking. Following exposure to 42 US billion-dollar weather disasters (severe storm, flood, flood/severe storm, tropical cyclone and winter storm) between 2011 and 2016, we used a difference-in-differences (DID) approach to quantify changes in the rates of emergency department (ED) visits, nonelective hospitalizations and mortality between fee-for-service Medicare beneficiaries in affected compared to matched control counties in post-disaster weeks 1, 1-2 and 3-6. Overall, disasters were associated with higher rates of ED utilization in affected counties in post-disaster week 1 (DID of 1.22% (95% CI, 0.20% to 2.25%; P < 0.020)) through week 2. Nonelective hospitalizations were unchanged. Mortality was higher in affected counties in week 1 (DID of 1.40% (95% CI, 0.08% to 2.74%; P = 0.037)) and persisted for 6 weeks. Counties with the greatest loss and damage experienced greater increases in ED and mortality rates compared to all affected counties. Thus, billion-dollar weather disasters are associated with excess ED visits and mortality in Medicare beneficiaries. Tracking these outcomes is important for adaptation that protects patients and communities, health system resilience and policy.

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