Hurricane Exposure and 30-Day Hospitalization or Death in Older Adults Using Medical Devices

Researchers used North Carolina Medicare data from 2015–2019 to assess short-term outcomes among beneficiaries aged 65 years or older with recent use of electricity-dependent durable medical equipment. Monthly cohorts were classified as exposed or unexposed to Hurricanes Matthew (2016) and Florence (2018) using FEMA county-level disaster declarations. Exploratory analyses instead defined exposure using residential flooding data from the North Carolina Flood Extent Archive. The primary outcome was all-cause hospitalization or death within 30 days; controlled interrupted time-series models assessed immediate and sustained changes.

With FEMA-based exposure definitions, neither hurricane was associated with a significant immediate change in the outcome, but a sustained increase followed Hurricane Matthew. Flood-based analyses found stronger and more consistent associations, especially at higher flooding thresholds and among Black beneficiaries. The authors conclude that broad disaster declarations may obscure differences in exposure and health effects. The findings suggest that higher-resolution flood measures could improve surveillance and help target preparedness resources for medically vulnerable people. The supplied abstract does not report effect estimates, and the analyses are observational; it does not establish that flooding caused the outcomes or evaluate specific preparedness interventions.