Disaster Preparedness: Insights from Characteristic Differences between Appalachian and Non-Appalachian Pediatric Emergency Networks

Introduction: Living in the Appalachian Region of the United States (US) has been linked to poorer pediatric health outcomes as well as a lack of emergency department and hospital surge capacity during disasters.

Purpose: We describe the characteristics of the Appalachian and non-Appalachian pediatric emergency networks in the US to determine if pediatric healthcare networks in Appalachia differ substantively from networks elsewhere in the US focusing on size, whether they were inter- or intra-state networks, and, most importantly, intensity of collaboration – factors impacting on pediatric disaster preparedness capabilities.

Methods: Data were collected using a two-stage survey process. The first survey was used to identify networks. The second survey assessed the disaster preparedness capabilities and achievements of each identified network, the degree of fund sharing, and the intensity and formality of information sharing among network partners. Networks were separated into Appalachia or non-Appalachia networks based on state location.

Results: Appalachian networks were more likely to be interstate and operating at the highest stage of network development compared to non-Appalachian networks, but were less likely to share funding among network partners.

Implications: Despite consistently insufficient pediatric capacity, particularly for disasters, and repeated calls for collaboration among pediatric care providers, only three out of seventeen identified pediatric networks were operating in Appalachia. Operating in Appalachia was associated with less fund sharing, although Appalachian networks were more likely to have achieved the highest stage of network development. Developing new pediatric networks and increasing the intensity of collaboration (i.e., increased levels of fund sharing) among existing networks may improve network operations, collaboration, disaster preparedness, and health outcomes in Appalachian states.