{"title":"重症监护结果中种族差异的来源:单中心分析。","authors":"Meera Mody, Kirby D Gong, Robert D Stevens","doi":"10.1353/hpu.2025.a967342","DOIUrl":null,"url":null,"abstract":"<p><p>There has been substantial documentation of racial and ethnic disparities in health outcomes, and a growing body of research on critical care outcomes specifically. In this paper, we seek to quantify the sources of racial disparities in a single urban intensive care unit (ICU), at Johns Hopkins Hospital in Baltimore, Maryland. Between 2014 and 2021, we document significant disparities in in-unit mortality, and length of ICU stay between racial and ethnic minority group patients versus White patients. Using the ZIP-Code and sociodemographic information collected on patients, we quantify the extent to which the disparities can be attributed to the observable socioeconomic and physiological factors. We find that socioeconomic factors and the Sequential Organ Failure Assessment (SOFA) score-a measure of ICU acuity-explain the Black-White, Hispanic-White, and Asian-White gaps in length of stay, and the Hispanic-White and Asian-White gaps in mortality. The SOFA score fully explains the Black-White gap in mortality outcomes, and socioeconomic factors surprisingly offset these gaps.</p>","PeriodicalId":48101,"journal":{"name":"Journal of Health Care for the Poor and Underserved","volume":"36 3","pages":"971-986"},"PeriodicalIF":1.2000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Sources of Racial Disparities in Critical Care Outcomes: A Single Center Analysis.\",\"authors\":\"Meera Mody, Kirby D Gong, Robert D Stevens\",\"doi\":\"10.1353/hpu.2025.a967342\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>There has been substantial documentation of racial and ethnic disparities in health outcomes, and a growing body of research on critical care outcomes specifically. In this paper, we seek to quantify the sources of racial disparities in a single urban intensive care unit (ICU), at Johns Hopkins Hospital in Baltimore, Maryland. Between 2014 and 2021, we document significant disparities in in-unit mortality, and length of ICU stay between racial and ethnic minority group patients versus White patients. Using the ZIP-Code and sociodemographic information collected on patients, we quantify the extent to which the disparities can be attributed to the observable socioeconomic and physiological factors. We find that socioeconomic factors and the Sequential Organ Failure Assessment (SOFA) score-a measure of ICU acuity-explain the Black-White, Hispanic-White, and Asian-White gaps in length of stay, and the Hispanic-White and Asian-White gaps in mortality. The SOFA score fully explains the Black-White gap in mortality outcomes, and socioeconomic factors surprisingly offset these gaps.</p>\",\"PeriodicalId\":48101,\"journal\":{\"name\":\"Journal of Health Care for the Poor and Underserved\",\"volume\":\"36 3\",\"pages\":\"971-986\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Health Care for the Poor and Underserved\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1353/hpu.2025.a967342\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"HEALTH POLICY & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Health Care for the Poor and Underserved","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1353/hpu.2025.a967342","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"HEALTH POLICY & SERVICES","Score":null,"Total":0}
Sources of Racial Disparities in Critical Care Outcomes: A Single Center Analysis.
There has been substantial documentation of racial and ethnic disparities in health outcomes, and a growing body of research on critical care outcomes specifically. In this paper, we seek to quantify the sources of racial disparities in a single urban intensive care unit (ICU), at Johns Hopkins Hospital in Baltimore, Maryland. Between 2014 and 2021, we document significant disparities in in-unit mortality, and length of ICU stay between racial and ethnic minority group patients versus White patients. Using the ZIP-Code and sociodemographic information collected on patients, we quantify the extent to which the disparities can be attributed to the observable socioeconomic and physiological factors. We find that socioeconomic factors and the Sequential Organ Failure Assessment (SOFA) score-a measure of ICU acuity-explain the Black-White, Hispanic-White, and Asian-White gaps in length of stay, and the Hispanic-White and Asian-White gaps in mortality. The SOFA score fully explains the Black-White gap in mortality outcomes, and socioeconomic factors surprisingly offset these gaps.
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.