• Rachel L Charney, Terri Rebmann, Cybill R Esguerra, Charlene W Lai, and Preeti Dalawari.
• Departments of Pediatrics, Division of Emergency Medicine, Saint Louis University, St Louis, Missouri.
• Disaster Med Public Health Prep. 2013 Apr 1; 7 (2): 167-74.

ObjectiveThe public's expectations of hospital services during disasters may not reflect current hospital disaster plans. The objective of this study was to determine the public's expected hospital service utilization during a pandemic, earthquake, and terrorist bombing.MethodsA survey was distributed to adult patients or family members at 3 emergency departments (EDs). Participants identified resources and services they expect to need during 3 disaster scenarios. Linear regression was used to describe factors associated with higher expected utilization scores for each scenario.ResultsOf the 961 people who participated in the study, 66.9% were women, 47.5% were white, and 44.6% were black. Determinants of higher pandemic resource utilization included persons who were younger (P < .01); non-white (P < .001); had higher ED visits (P < .01), hospitalization (P = .001), or fewer primary care provider visits (P = .001) in the past year; and did not have a reunification plan (P < .001). Determinants of higher earthquake resource utilization included persons who were non-white (P < .001); who were a patient or spouse (vs parent) participating in the study (P < .05 and P = .001); and had higher ED visits in the past year (P = .001). Determinants of higher bombing resource utilization included persons who were female (P = .001); non-white (P < .001); had higher ED (P = .001) or primary care provider (P < .01) visits in past year; and experienced the loss of home or property during a past disaster (P < .05).ConclusionsPublic expectations of hospitals during disasters are high, and some expectations are inappropriate. Better community disaster planning and public risk communication are needed.

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