Research Interests—Dr. Kanter's health services research investigates the balance between pediatric hospital resources and community needs, including the alterations necessary to provide effective services in major regional emergencies.
Recent studies have explored the distribution [1], use [2-5], and relative quality [6] of regional pediatric hospital services. In disasters, hospitals may be overwhelmed by large surges of patients, especially if an emergency involves large numbers of children [5]. In order to extend existing hospital resources in a disaster, it may be necessary to alter standards of care, providing only essential lifesaving interventions. Empirical data on resources and projected needs in New York City suggest that plausible modifications in standards of care would usually meet federal surge targets [7], and would reduce disaster mortality rates for surges within the limits of federal planning targets [8].
A study in progress explores professional expert opinion regarding the hospital services that should be regarded as essential in disaster responses, even while less important interventions are limited. In order to improve planning for disaster recovery, another study in progress estimates the impact of a major community disruption on the health of children. In addition to the injuries directly caused by a disaster, preliminary results suggest that in socioeconomically disadvantaged areas, rates of severe illness requiring hospitalization, especially asthma, increase in the weeks after a disaster [9].
