Canadian Team Develops Algorithm to Pinpoint People at High Risk During Natural Disasters

During any natural disaster, rescue teams scramble to reach those at the highest risk, which vey often are older members of the community. Advancements in medicine have not only led to a growing population of people over 60, but have also allowed them to age in place at higher rates.

"Frailty combined with social isolation can mean that older adults still living at home have nowhere to turn during emergencies…it's a very real concern," said John Hirdes, a researcher in the Faculty of Applied Health Sciences at the University of Waterloo in Ontario, Canada.

But what if government agencies had a tool to pinpoint the potential locations of those people while a disaster was unfolding?

Hirdes and his colleagues set out to create an algorithm that could do just that. They used information from a home care assessment by interRAI, an international consortium of researchers aimed at improving care for vulnerable populations through data and analytics tools. The data focused on vulnerable persons in the province of Ontario based on their use of home care services.

With a population of over 275,000 in their sample, the team developed its Vulnerable Persons at Risk (VPR) and VPR Plus decision tools through cross tabulation, bivariate logistic regression, Kaplan-Meier survival plotting, and Cox proportional hazards ratios calculations.

In ordinary circumstances, both algorithms were “highly predictive” of vulnerability indicators like mortality and hospital admissions. The team believes that accuracy will be particularly handy in case of emergencies.

"It has the potential to save hundreds of lives," Hirdes said, adding that, "It's a tool that should be top of mind for any part of the country at risk of natural disasters." A new report on the work was recently published in the Journal of Emergency Management.

His country—Canada—has a few key advantages over the United States when it comes to emergency management. Several of its provinces (including Canada) require an interRAI assessment of all long-term home care patients either every 6 months or every year to determine their needs. That means there is often a consolidated, relatively up-to-date database on such populations.

The country’s single payer system doesn’t necessarily ensure better interoperability, but it’s certainly a less fragmented healthcare ecosystem than that of the US. Domestic efforts to create integrated protocols for disaster management are an ongoing struggle.