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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Bibliographic Details
Published in:Health affairs (Millwood, Va.) Vol. 39; no. 7; pp. 1253 - 12
Main Authors: Azar, Kristen M J, Shen, Zijun, Romanelli, Robert J, Lockhart, Stephen H, Smits, Kelly, Robinson, Sarah, Brown, Stephanie, Pressman, Alice R
Format: Journal Article
Language:English
Published: United States The People to People Health Foundation, Inc., Project HOPE 01.07.2020
Subjects:
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
Online Access:Get full text
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Summary: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.
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ISSN:0278-2715
2694-233X
1544-5208
2694-233X
DOI:10.1377/hlthaff.2020.00598