Poverty, Comorbidity, and Ethnicity: COVID-19 Outcomes in a Safety Net Health System.
Ethn Dis
; 32(2): 113-122, 2022.
Article
in English
| MEDLINE | ID: covidwho-1818894
ABSTRACT
Objective:
To determine if race-ethnicity is correlated with case-fatality rates among low-income patients hospitalized for COVID-19. ResearchDesign:
Observational cohort study using electronic health record data. Patients All patients assessed for COVID-19 from March 2020 to January 2021 at one safety net health system.Measures:
Patient demographic and clinical characteristics, and hospital care processes and outcomes.Results:
Among 25,253 patients assessed for COVID-19, 6,357 (25.2%) were COVID-19 positive 1,480 (23.3%) hospitalized; 334 (22.6%) required intensive care; and 106 (7.3%) died. More Hispanic patients tested positive (51.8%) than non-Hispanic Black (31.4%) and White patients (16.7%, P<.001]. Hospitalized Hispanic patients were younger, more often uninsured, and less likely to have comorbid conditions. Non-Hispanic Black patients had significantly more diabetes, hypertension, obesity, chronic kidney disease, and asthma (P<.05). Non-Hispanic White patients were older and had more cigarette smoking history, COPD, and cancer. Non-Hispanic White patients were more likely to receive intensive care (29.6% vs 21.1% vs 20.8%, P=.007) and more likely to die (12% vs 7.3% vs 3.5%, P<.001) compared with non-Hispanic Black and Hispanic patients, respectively. Length of stay was similar for all groups. In logistic regression models, Medicaid insurance status independently correlated with hospitalization (OR 3.67, P<.001) while only age (OR 1.076, P<.001) and cerebrovascular disease independently correlated with in-hospital mortality (OR 2.887, P=.002).Conclusions:
Observed COVID-19 in-hospital mortality rate was lower than most published rates. Age, but not race-ethnicity, was independently correlated with in-hospital mortality. Safety net health systems are foundational in the care of vulnerable patients suffering from COVID-19, including patients from under-represented and low-income groups.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Ethnicity
/
COVID-19
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Humans
Country/Region as subject:
North America
Language:
English
Journal:
Ethn Dis
Journal subject:
Social Sciences
/
Public Health
Year:
2022
Document Type:
Article
Affiliation country:
Ed.32.2.113
Similar
MEDLINE
...
LILACS
LIS