Hospital Collaboration with Public Safety Organizations on Bioterrorism Response

Abstract

Objective. To identify hospital characteristics that predict collaboration with public safety organizations on bioterrorism response plans andmass casualty drills. Methods. The 2003 and2004 Bioterrorism andMass Casualty Supplements to the National Hospital Ambulatory Medical Care Survey examined collaboration with emergency medical services (EMS), hazardous materials teams (HAZMAT), fire departments, andlaw enforcement. The sample included 112 geographic primary sampling units and1,110 hospitals. Data were weighted by inverse selection probability, to yield nationally representative estimates. Characteristics included residency andmedical school affiliation, bed capacity, ownership, urbanicity andJoint Commission accreditation. The response rate was 84.6%. Chi-square analysis was performed with alpha set at p < 0.05. Logistic regression modeling yielded odds ratios with 95% confidence intervals. Results. During a bioterrorism incident, 68.9% of hospitals would contact EMS, 68.7% percent law enforcement, 61.6% fire departments, 58.1% HAZMAT, and42.8% all four. About 74.2% had staged mass casualty drills with EMS, 70.4% with fire departments, 67.4% with law enforcement, 43.3% with HAZMAT, and37.0% with all four. Predictors of drilling with some or all of these public safety organizations included larger bed capacity, nonprofit andproprietary ownership, andJCAHO accreditation. Medical school affiliation was a negative predictor of drilling with EMS.Conclusions. The majority of hospitals involve public safety organizations in their emergency plans or drills. Bed capacity was most predictive of drilling with these organizations. Medical school affiliation was the only characteristic negatively associated with drilling.

Key words:

• bioterrorism
• emergency medical services
• public safety
• hospital