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There is a great deal of literature in the areas of: (1) medical demography; (2) the effect of disasters on first re- sponders; (3) measuring the immediate demographic and social effects of a disaster; and (4) the short and long term eco- nomic and financial effects of disasters. However, there is very little if anything about the demographic effects of large scale disasters on medical providers once rescue operations have been completed and operations move into the relief and recovery/rehabilitation phases associated with a disaster. This paper seeks to bridge this gap by providing as a "recov- ery/rehabilitation" case study, estimates of the effects of Hurricane Katrina on the client populations and candidates for a specific medical procedure in the service areas associated with two medical facilities on the Mississippi gulf coast. The es- timates presented here show that Katrina had a substantial demographic impact and that this translated into an adverse im- pact on the client base of both medical facilities. Although the results come from a single case study, the results suggest that the effects of a disaster can have substantial impacts on medical care providers and their ability to continue business that goes well beyond physical damage. That is, these results suggest that the impact of demographic effects of a disaster on a client base can be more important than physical damage, a fact that does not appears to be widely recognized. The first step in effectively dealing with a disaster is the presence of a plan and it is typical of organizations to have both "dis- aster recovery" plans and "business continuation" plans. Given the long term effects of Katrina on client populations found in this case study, it would be prudent that medical care providers include estimates of demographic impacts on their client populations in these plans, particularly in regard to the long-term "effects horizon" of a given disaster

Hurricane Katrina: A Case Study of its Impacts on Medical Service Providers and Their Client Populations