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.