Environmental disasters can affect how individuals use healthcare services. We use the Flint water crisis to examine rates of avoidable emergency care, which is costly to both providers and patients, and office visits. In September 2015, the city of Flint issued a lead advisory to its residents, alerting them of increased lead levels in their drinking water, resulting from the switch in water source from Lake Huron to the Flint River. Using Medicaid claims for 2013 to 2016, we find that this advisory, which became national news, increased the share of enrollees who had lead tests performed by 1.7 percentage points. Additionally, it increased office visits immediately, and led to a reduction of 4.9 preventable, non-emergent, and primary-care-treatable emergency room visits per 1,000 eligible children (8.3 percent). This decrease is present in shifts from emergency room visits to office visits across several common conditions. Our analysis suggests that children were more likely to receive care from the same clinic following lead tests and that establishing care reduced the likelihood parents would take their children to emergency rooms for conditions that would have been treatable in an office setting. Our results show that environmental disasters that induce health checkups can prompt individuals to change their type and venue of health care, particularly moving away from emergency departments and toward the office setting.

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环境灾难后的医疗保健：来自弗林特的证据

环境灾难会影响个人使用医疗保健服务的方式。我们使用弗林特水危机来检查可避免的紧急护理率，这对提供者和患者来说都是昂贵的，以及办公室访问。2015 年 9 月，弗林特市向其居民发布了一份铅含量警告，提醒他们饮用水中的铅含量增加，这是由于水源从休伦湖转向弗林特河所致。使用 2013 年至 2016 年的 Medicaid 索赔，我们发现这项成为全国性新闻的建议使接受铅测试的参保者的比例增加了 1.7 个百分点。此外，它立即增加了办公室就诊次数，并导致每 1,000 名符合条件的儿童减少 4.9 次可预防、非急诊和初级保健可治疗的急诊室就诊次数（8.3%）。这种减少体现在从急诊室就诊到几种常见情况的办公室就诊的转变中。我们的分析表明，儿童更有可能在铅测试后从同一诊所接受护理，并且建立护理降低了父母将孩子带到急诊室治疗在办公室环境中可以治疗的疾病的可能性。我们的研究结果表明，引发健康检查的环境灾难会促使个人改变他们的医疗保健类型和地点，尤其是从急诊室转移到办公室环境。我们的分析表明，儿童更有可能在铅测试后从同一诊所接受护理，并且建立护理降低了父母将孩子带到急诊室治疗在办公室环境中可以治疗的疾病的可能性。我们的研究结果表明，引发健康检查的环境灾难会促使个人改变他们的医疗保健类型和地点，尤其是从急诊室转移到办公室环境。我们的分析表明，儿童更有可能在铅测试后从同一诊所接受护理，并且建立护理降低了父母将孩子带到急诊室治疗在办公室环境中可以治疗的疾病的可能性。我们的研究结果表明，引发健康检查的环境灾难会促使个人改变他们的医疗保健类型和地点，尤其是从急诊室转移到办公室环境。