It has been 10 years since a category five hurricane, stretching 400 miles across with sustained winds of more than 100 miles per hour, battered the state of Louisiana, displacing residents from their homes.
Following Hurricane Katrina, temporary emergency state Medicaid waivers were established to provide short-term insurance to dislocated individuals.
Dr. Troy Quast, University of South Florida College of Public Health associate professor, and his colleague conducted research analyzing the health care utilization and health outcomes of diabetic children displaced by Hurricane Katrina.
His research, “Diabetes Care Provided to Children Displaced by Hurricane Katrina” published in the Disaster Medicine and Public Health Preparedness August issue, specifically examined children with diabetes enrolled in the Texas Medicaid waiver program, “TexKat.” TexKat was the largest of the federal government emergency waivers issued following Katrina.
“Emergency Medicaid waivers haven’t been used that often, and there have been very few studies of how they performed,” Dr. Quast said. “Disasters are unpredictable, but we know they are going to happen and we think it’s important to know how these waivers perform and how they can be revised to better serve people in future disasters.”
Dr. Quast compared enrollment and claims data from 2004 to 2006 of diabetic children displaced from Louisiana with those of children who lived in areas less affected by Hurricane Katrina. Quast divided the three year period into three sections: pre-Katrina, during TexKat, and post-TexKat. In each of those periods, Dr. Quast examined the frequency of four diabetes maintenance tests (glycated hemoglobin, eye exams, microalbumin test, and thyroid test) and one diabetes complication (diabetic ketoacidosis).
Results indicated that children enrolled in the waiver program did not experience a decrease in care, however, after the waiver period ended, there was a drop in care and an increase in complications.
“We see during the post-TexKat period, that there was an uptake in complications, and the rate of exams fell pretty significantly,” Dr. Quast said.
Dr. Quast indicates that more is needed in the post-waiver period to ensure enrollees continue to receive proper care.
“A concern from our study indicates that there needs to be some sort of transition for people after waivers expire, and maybe public health officials need to consider ways that we can ensure that these individuals are maintaining the appropriate healthcare after the waiver ends,” Quast said.
While the Texas Hurricane Katrina emergency wavier appeared to have functioned well in the period immediately following the hurricane, data shows more needs be done to assist enrollees in continuing their care once they are enrolled back into traditional Medicaid. Dr. Quast recommends that more outreach and communication be conducted with enrollees.
“Disasters are inevitable and this is one way we can become better prepared,” Dr. Quast said.
Dr. Quast’s research, funded by the National Institutes of Health, will continue to examine how children fared after the storm. They plan to also examine the areas of asthma and mental health.
Dr. Quast joined the department of health policy and management at the College of Public Health in 2015. His research interests include the impact of economic conditions oh health status, Medicaid policy, and the impact of natural disasters on health status and the utilization of health services. He obtained his master’s degree from the University of Texas and his doctoral degree from the University of Florida.