Disaster planning for healthcare organizations is underfunded, resulting in a system that is poorly equipped for an increasing number of natural and man-made disasters.
Lack of funding has limited the ability of various constituents to organize and test the existing infrastructure to see if it can effectively respond to the healthcare demands of disasters, said the report, from the Health Research Institute of PriceWaterhouseCoopers.
In addition, the research by the New York-based consulting firm found that facility and staff resources are limited; public health and private sector plans for delivering medical care are inadequately coordinated; and communications and tracking systems are incompatible.
While the events of Sept. 11, 2001, spurred the nation to improve emergency planning, there's still a long way to go, said Hindy Shaman, director of the Health Research Institute.
"We're in better shape than we were before 9-11," she said. "But there are a lot of areas where the system is not integrated. There are some silos of information and some gaps that undermine the progress. We're never done with disaster preparedness; it's something that needs constant investment."
Because of thin financial margins, healthcare organizations have not set aside enough resources in anticipation of disasters, which are occurring once a week in the U.S., on average, Shaman said.
"The private sector is not incented to have resources set aside in case of disaster," she said. Rather, healthcare organizations operate under the assumption that, just like in the supply sphere, they'll get what they need just in time, or have just enough, to deal with a disaster. However, because of the disruptions caused by disasters and the massive increase in resources required, that's an unrealistic assumption.
The country also needs to look anew at how disaster planning is financed, Shaman said. The report indicates that funding approaches do not support systematic community planning. Because funding needs to be applied for annually, long-term planning is discouraged, and hospital executives don't believe that too much effort is required to gain funding.
The federal government is spending only $1.3 billion through the Public Health Emergency Preparedness Program and Hospital Preparedness Program, which averages only $4.30 per person per year. Based on current HPP funding levels, each hospital was eligible to receive an average of $82,500 in 2007.
"This level of funding begs the question of how well a hospital could prepare by spending $82,500," the report said. "For some hospitals, these grant monies, may seem unworthy of their time and attention."
Primary care physicians are the least likely to receive disaster preparedness training and the least likely to be prepared. Fewer than 20 percent of primary care physicians said they were "well-prepared" about what to do in the event of a disaster.
"It's not just a federal issue in terms of funding, but there's a role for state and local funding as well," Shaman said.