Disparities In Outcomes Among COVID-19 Patients In A Large Health Care System In California

As the novel coronavirus disease (COVID-19) pandemic spreads throughout the United States, evidence is mounting that racial and ethnic minorities and socioeconomically disadvantaged groups are bearing a disproportionate burden of illness and death. We conducted a retrospective cohort analysis of COV...

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Vydáno v:	Health affairs (Millwood, Va.) Ročník 39; číslo 7; s. 1253 - 12
Hlavní autoři:	Azar, Kristen M J, Shen, Zijun, Romanelli, Robert J, Lockhart, Stephen H, Smits, Kelly, Robinson, Sarah, Brown, Stephanie, Pressman, Alice R
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States The People to People Health Foundation, Inc., Project HOPE 01.07.2020
Témata:	Adult Adults African Americans Age Factors Aged At risk populations California - epidemiology Clinical outcomes Cohort analysis Cohort Studies Coronavirus Infections - epidemiology Coronavirus Infections - prevention & control Coronaviruses COVID-19 Databases, Factual Disadvantaged Electronic health records Electronic medical records Ethnic differences Ethnic groups Ethnic Groups - statistics & numerical data Ethnicity Female Health care Health care access Health disparities Health services Healthcare Disparities - economics Healthcare Disparities - ethnology Hospitalization Humans Insurance Coverage - statistics & numerical data Male Medical records Middle Aged Minority & ethnic groups Minority groups Minority Groups - statistics & numerical data Mortality Pandemics Pandemics - prevention & control Pandemics - statistics & numerical data Patients Pneumonia, Viral - epidemiology Pneumonia, Viral - prevention & control Poverty - statistics & numerical data Prevalence Race Racial differences Racial inequality Regression analysis Retrospective Studies Risk analysis Risk Assessment Risk factors Sex Sex Factors Social factors Socioeconomic Factors Survival Analysis Viral diseases California United States > US COVID-19 Coronavirus Health policy Pandemics Socioeconomic status health disparities Racial disparities Systems of care Ethnic disparities
ISSN:	0278-2715, 2694-233X, 1544-5208, 2694-233X
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Shrnutí:	As the novel coronavirus disease (COVID-19) pandemic spreads throughout the United States, evidence is mounting that racial and ethnic minorities and socioeconomically disadvantaged groups are bearing a disproportionate burden of illness and death. We conducted a retrospective cohort analysis of COVID-19 patients at Sutter Health, a large integrated health system in northern California, to measure potential disparities. We used Sutter's integrated electronic health record to identify adults with suspected and confirmed COVID-19, and we used multivariable logistic regression to assess risk of hospitalization, adjusting for known risk factors, such as race/ethnicity, sex, age, health, and socioeconomic variables. We analyzed 1,052 confirmed cases of COVID-19 from the period January 1-April 8, 2020. Among our findings, we observed that compared with non-Hispanic white patients, non-Hispanic African American patients had 2.7 times the odds of hospitalization, after adjustment for age, sex, comorbidities, and income. We explore possible explanations for this, including societal factors that either result in barriers to timely access to care or create circumstances in which patients view delaying care as the most sensible option. Our study provides real-world evidence of racial and ethnic disparities in the presentation of COVID-19.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23
ISSN:	0278-2715 2694-233X 1544-5208 2694-233X
DOI:	10.1377/hlthaff.2020.00598