Racial Disparities in Mortality and Readmission Among COVID-19 Hospitalized Patients.

IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES
Aize Cao, Arielle M Fisher, Russell E Poland, Todd Gary, Jeffrey Schnipper, Kenneth Sands
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引用次数: 0

Abstract

We conducted a cross-sectional study to investigate racial disparities among patients hospitalized for COVID-19 using electronic health records from a large community-based health care system between March 2020 and February 2021. The primary outcomes were in-hospital mortality and 30-day readmission. Demographics, clinical characteristics, and socioeconomic factors were analyzed using logistic regression, with adjusted odds ratios (AOR) reported. The study identified 90,490 patients, including Hispanic (29%), White (45.5%), Black (17.3%), Asian (3.1%), and Others (4.1%). The mortality model demonstrated a strong performance with an area under curve (AUC) of 0.88 (95%CI=0.877-0.885) and a Brier score of 0.093 (95%CI=0.092-0.095). For the 30-day readmission model, the AUC was 0.726 (95%CI=0.717-0.734) with a Brier score of 0.091 (95%CI=0.088-0.093). Compared with Whites, Hispanics exhibited a higher risk of mortality (AOR=1.23; 95%CI=1.16-1.31) but a lower likelihood of readmission (AOR=0.89; 95%CI=0.83-0.97). These findings highlight the critical need for targeted health management strategies across different racial and ethnic groups.

COVID-19住院患者死亡率和再入院率的种族差异
我们进行了一项横断面研究,利用2020年3月至2021年2月期间来自大型社区医疗保健系统的电子健康记录,调查COVID-19住院患者的种族差异。主要结局为住院死亡率和30天再入院率。使用逻辑回归分析人口统计学、临床特征和社会经济因素,并报告调整优势比(AOR)。该研究确定了90490例患者,包括西班牙裔(29%)、白人(45.5%)、黑人(17.3%)、亚洲人(3.1%)和其他(4.1%)。死亡率模型曲线下面积(AUC)为0.88 (95%CI=0.877 ~ 0.885), Brier评分为0.093 (95%CI=0.092 ~ 0.095)。对于30天再入院模型,AUC为0.726 (95%CI=0.717-0.734), Brier评分为0.091 (95%CI=0.088-0.093)。与白人相比,西班牙裔美国人的死亡率更高(AOR=1.23;95%CI=1.16-1.31),但再入院的可能性较低(AOR=0.89;95% ci = 0.83 - -0.97)。这些发现强调了在不同种族和族裔群体中制定有针对性的健康管理战略的迫切需要。
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来源期刊
CiteScore
2.00
自引率
7.10%
发文量
154
期刊介绍: The journal has as its goal the dissemination of information on the health of, and health care for, low income and other medically underserved communities to health care practitioners, policy makers, and community leaders who are in a position to effect meaningful change. Issues dealt with include access to, quality of, and cost of health care.
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