Medication Preparedness for Emergency Flooding Situations of Public Hospitals in Central Thailand: A Case Study of Flooding Crisis in 2011

Introductions: Hospitals situated in central Thailand are at high risk of emergency flooding situations.  Medication preparedness for emergency flooding situations (EFS) is important for public hospitals, where most healthcare services are delivered to the Thai people. This research aimed to survey medication preparedness for EFS of public hospitals in central Thailand. Methods : Medication preparedness was surveyed using a questionnaire designed for this study based on the Medical and Public Health Preparedness Plan 2010. The questionnaires were sent to 76 public hospitals in 8 provinces in the central region affected by the floods in 2011. Overall medication preparedness was assessed on 7 components into 3 levels: high (score 6-7), moderate (3-5), and low (0-2). Results : Thirty-two hospitals returned the questionnaire (42.1%response rate). Five from seven tertiary care hospitals (71.4%) and 17 from 25 community hospitals (68.0%) reported of having moderate level of medication preparedness for EFS. Twenty-nine hospitals (90.6%) had performed risk assessment of flood, created a list and determined minimum stock of emergency medications for flood. Twenty-six hospitals (84.4%) had established a public health emergency response plan for flood and assigned specific roles to each responding unit. About half of the hospitals (46.9%) had tabletop exercises for emergency response plan. Eight from thirty-two hospitals (25.0%) reported of creating specific medication lists for EFS. A list of emergency medications for EFS was created by hospital Pharmaceutical and Therapeutic Committee, covering medications for common diseases, infectious diseases and chronic diseases. Emergency medications for EFS were stocked for a minimum of 2-3 months. Thirty hospitals (93.8%) had established a supply network for EFS. Eight from thirty-two hospitals (25.0%) had had an informal agreement with manufacturers or distributors on speed delivery of intravenous solutions. Twenty hospitals (62.5%) created a database of EFS organizations and contact persons. Eleven hospitals (34.4%) provided public health personnel trainings on emergency medications, medication delivery, and medication management for chronic diseases for personnel at district hospitals, sub-district hospitals, local administrative authorities, and health volunteers. Only 5 hospitals (26.3%) provided information on emergency medication for patients and public. Conclusion : Most hospitals had moderate level of medication preparedness for EFS. Functional exercise of emergency plan, establishment of emergency medication lists, and public education on emergency medication for EFS should be carried out.