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December 2, 2002

Center gets $270K to study terror effects on health center

By Tia Webster

The Emory Center on Health Outcomes and Quality (CHOQ) has received $270,000 from the federal Agency for Healthcare Research and Quality to study the effects of last year’s terror and anthrax attacks on the health care system. The findings will be used to help the health care community understand, anticipate and better prepare for the impact of possible future terrorism.

A team from CHOQ and the Center for Public Health Preparedness and Research, both in the Rollins School of Public Health, will study the effects of stress-aggravated or stress-related diseases on health care demands and costs.

“Terrorism brought about fear and disruption of our daily lives that left a psychological aftershock,” said co-principal investigator Diane Green, research assistant professor in public health. “Anxiety disorders, post-traumatic stress disorder and depression may be the tip of the iceberg for health effects and demands on health systems.”

“Certain types of health care utilization, especially of mental health services, have probably increased since last fall, and the magnitude of the effect may depend on how close individuals were to the World Trade Center bombings and to the anthrax victims,” said fellow co-principal investigator Ruth Berkelman, Rollins Professor and director of Center for Public Health Preparedness and Research. “We expect to see fewer effects further from New York and the East Coast, but some effects on mental health and other services may be nationwide.

“Immediately following a major terrorism event like 9/11,” Berkelman continued, “it is unclear whether people will increase or decrease visits such as those for routine care, minor illnesses or elective medical procedures.”

Researchers will use data collected from certain Aetna health plans because of the insurer’s diverse membership; it has members in 47 states and offers both HMO and PPO-based products. Using the statistical information, researchers will be able to examine multiple health outcomes and stratify analyses by location, type of product and demographics. To determine costs to the health care system, utilization patterns will be studied in inpatient, outpatient and emergency department settings.

The study population will be selected using people in the areas directly affected by the terrorist events of September–October 2001 (Washington, parts of New York, New Jersey and Florida) and a sample of the member population in several other areas based on the nine standard divisions defined by the U.S. Census Bureau.

Green and Berkelman said that while stress has been recognized as a risk factor for numerous illnesses, less is known about the clinical effects of terrorism on health care utilization for mental health disorders (such as depression and anxiety disorders) as well as physical conditions such as cardiovascular disease and asthma.

“This study is a contribution to national preparedness,” Berkelman said. “By understanding the impact of specific terror-related events, the health care community is better prepared to anticipate both the short- and long-term impact of future events.”

The CHOQ is a multischool, multidisciplinary group within the Woodruff Health Sciences Center created to conduct outcomes-based research that includes assessing and improving methods for measuring quality of care and designing interventions to improve health outcomes. It works with consumers, physicians and insurers to evaluate and implement new approaches for improving quality of care.