Health problems presented to family practices in the Netherlands 1 year before and 1 year after a disaster.
SourceJABFM : Journal of the American Board of Family Medicine, 20, 6, (2007), pp. 548-56
Article / Letter to editor
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Primary and Community Care
JABFM : Journal of the American Board of Family Medicine
SubjectEBP 3: Effective Primary Care and Public Health; NCEBP 7: Effective primary care and public health
BACKGROUND: Disasters often have negative health consequences. Studies of health problems presented in family practice before and after a disaster are rare. The present study analyzed health problems before and after a disaster and predictors of increased morbidity after the disaster as presented in family practice. METHODS: A matched cohort study design with measurements 1 year before the disaster and 1 year after the disaster. Victims (N = 9183) and matched controls (N = 7066) were surveyed in the electronic medical records of 30 family practices after the explosions of a fireworks depot in The Netherlands. All health problems were registered using the International Classification of Primary Care. RESULTS: Victims showed significantly higher prevalence rates for psychological problems after the disaster than before the disaster (422 vs133 per 1000 person-years; P < .001) and for problems of the musculoskeletal system (450 vs 401 per 1000 person-years; P < .05). Relocation because of the disaster (odds ratio, 10.65; 95% confidence interval, 8.15-13.94) and, to a lesser degree, psychological morbidity before the disaster (odds ratio, 2.31; 95% confidence interval, 1.42-3.76) were the strongest predictors of psychological problems after the disaster. CONCLUSION: The results suggested that forced relocation and a history of psychological problems were risk factors to post-disaster psychological problems of victims presenting to a family practice.
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