Racial disparities in patients hospitalized for COVID-19

Mirajkar, Amber; Oswald, Adam; Rivera, María Dolores González; Logan, Gideon; MacIntosh, Tracy; Walker, Ayanna; Lebowitz, David; Ganti, Latha

doi:10.1016/j.jnma.2023.06.006

Cited by 5 publications

(4 citation statements)

References 1 publication

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“…This finding is similar to those of prior studies in community residents that also noted higher hospitalization rates for Black individuals but similar mortality [ 42 , 43 ]. However, Black individuals hospitalized with COVID-19 were younger (average age of 60), compared to White patients (average age of 71), and 15.6% required admission to intensive care, compared to 13.9% of non-Black patients [ 44 , 45 ].…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Older Adults with Alzheimer’s Disease Who Were Hospitalized during the COVID-19 Pandemic: A Secondary Data Analysis

Wang,

Hendrix,

Lee

et al. 2024

IJERPH

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We aim to investigate the relationships between the population characteristics of patients with Alzheimer’s Disease (AD) and their Healthcare Utilization (HU) during the COVID-19 pandemic. Electronic health records (EHRs) were utilized. The study sample comprised those with ICD-10 codes G30.0, G30.1, G30.8, and G30.9 between 1 January 2020 and 31 December 2021. Pearson’s correlation and multiple regression were used. The analysis utilized 1537 patient records with an average age of 82.20 years (SD = 7.71); 62.3% were female. Patients had an average of 1.64 hospitalizations (SD = 1.18) with an average length of stay (ALOS) of 7.45 days (SD = 9.13). Discharge dispositions were primarily home (55.1%) and nursing facilities (32.4%). Among patients with multiple hospitalizations, a negative correlation was observed between age and both ALOS (r = −0.1264, p = 0.0030) and number of hospitalizations (r = −0.1499, p = 0.0004). Predictors of longer ALOS included male gender (p = 0.0227), divorced or widowed (p = 0.0056), and the use of Medicare Advantage and other private insurance (p = 0.0178). Male gender (p = 0.0050) and Black race (p = 0.0069) were associated with a higher hospitalization frequency. We recommend future studies including the co-morbidities of AD patients, larger samples, and longitudinal data.

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Section: Discussionmentioning

confidence: 99%

Characteristics of Older Adults with Alzheimer’s Disease Who Were Hospitalized during the COVID-19 Pandemic: A Secondary Data Analysis

Wang,

Hendrix,

Lee

et al. 2024

IJERPH

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“… 35–37 As noted, the demographics of admitted patients fluctuated importantly across the pandemic, as did symptomatology, seemingly corresponding with dominant viral variants. 38–40 Thus, one might infer that patient response to viral variants was well reflected in patient characteristics at admission, resulting in no remaining ‘independent’ information from knowing the viral variant.…”

Section: Discussionmentioning

confidence: 99%

Evolution of serious and life-threatening COVID-19 pneumonia as the SARS-CoV-2 pandemic progressed: an observational study of mortality to 60 days after admission to a 15-hospital US health system

Murthy,

Gordon,

Lowry

et al. 2024

BMJ Open

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ObjectiveIn order to predict at hospital admission the prognosis of patients with serious and life-threatening COVID-19 pneumonia, we sought to understand the clinical characteristics of hospitalised patients at admission as the SARS-CoV-2 pandemic progressed, document their changing response to the virus and its variants over time, and identify factors most importantly associated with mortality after hospital admission.DesignObservational study using a prospective hospital systemwide COVID-19 database.Setting15-hospital US health system.Participants26 872 patients admitted with COVID-19 to our Northeast Ohio and Florida hospitals from 1 March 2020 to 1 June 2022.Main outcome measures60-day mortality (highest risk period) after hospital admission analysed by random survival forests machine learning using demographics, medical history, and COVID-19 vaccination status, and viral variant, symptoms, and routine laboratory test results obtained at hospital admission.ResultsHospital mortality fell from 11% in March 2020 to 3.7% in March 2022, a 66% decrease (p<0.0001); 60-day mortality fell from 17% in May 2020 to 4.7% in May 2022, a 72% decrease (p<0.0001). Advanced age was the strongest predictor of 60-day mortality, followed by admission laboratory test results. Risk-adjusted 60-day mortality had all patients been admitted in March 2020 was 15% (CI 3.0% to 28%), and had they all been admitted in May 2022, 12% (CI 2.2% to 23%), a 20% decrease (p<0.0001). Dissociation between observed and predicted decrease in mortality was related to temporal change in admission patient profile, particularly in laboratory test results, but not vaccination status or viral variant.ConclusionsHospital mortality from COVID-19 decreased substantially as the pandemic evolved but persisted after hospital discharge, eclipsing hospital mortality by 50% or more. However, after accounting for the many, even subtle, changes across the pandemic in patients’ demographics, medical history and particularly admission laboratory results, a patient admitted early in the pandemic and predicted to be at high risk would remain at high risk of mortality if admitted tomorrow.

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“…Race and ethnicity information was obtained from the Vizient CDB for each inpatient stay and coded as reported in Table 1 . Race and ethnicity are demographic characteristics for which differences in COVID-19 infection, hospitalization, morbidity, and mortality rates vary 36 and can therefore be associated with differences in costs of inpatient treatment. The weekly COVID-19 case rates (per 100 000 residents) in the patient’s zip code at the time of admission were included as indicators of potential hospital capacity constraints.…”

Section: Methodsmentioning

confidence: 99%

Inpatient Costs of Treating Patients With COVID-19

Kapinos,

Peters,

Murphy

et al. 2024

JAMA Netw Open

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ImportanceWith more than 6.2 million hospitalizations due to COVID-19 in the US, recognition of the average hospital costs to provide inpatient care during the pandemic is necessary to understanding the national medical resource use and improving public health readiness and related policies.ObjectiveTo examine the mean cost to provide inpatient care to treat COVID-19 and how it varied through the pandemic waves and by important sociodemographic patient characteristics.Design, Setting, and ParticipantsThis cross-sectional study used inpatient-level data from March 1, 2020, to March 31, 2022, extracted from a repository of clinical, administrative, and financial information covering 97% of academic medical centers across the US.Main Outcomes and MeasuresCost to produce care for each stay was calculated using direct hospital costs to provide care adjusted for geographic differences in labor costs using area wage indices.ResultsThe sample included 1 333 404 stays with a primary or secondary COVID-19 diagnosis from 841 hospitals. The cohort included 692 550 (52%) men, with mean (SD) age of 59.2 (17.5) years. The adjusted mean cost of an inpatient stay was $11 275 (95% CI, $11 252-$11 297) overall, increasing from $10 394 (95% CI, $10 228-$10 559) at the end of March 2020 to $13 072 (95% CI, $12 528-$13 617) by the end of March 2022. Patients with specific comorbidities had significantly higher mean costs than their counterparts: those with obesity incurred an additional $2924 in inpatient stay costs, and those with coagulation deficiency incurred an additional $3017 in inpatient stay costs. Stays during which the patient required extracorporeal membrane oxygenation (ECMO) had an adjusted mean cost of $36 484 (95% CI, $34 685-$38 284).Conclusions and RelevanceIn this cross-sectional study, an adjusted mean hospital cost to provide care for patients with COVID-19 increased more than 5 times the rate of medical inflation overall. This appeared to be explained partly by changes in the use of ECMO, which increased over time.

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Racial disparities in patients hospitalized for COVID-19

Cited by 5 publications

References 1 publication

Characteristics of Older Adults with Alzheimer’s Disease Who Were Hospitalized during the COVID-19 Pandemic: A Secondary Data Analysis

Characteristics of Older Adults with Alzheimer’s Disease Who Were Hospitalized during the COVID-19 Pandemic: A Secondary Data Analysis

Evolution of serious and life-threatening COVID-19 pneumonia as the SARS-CoV-2 pandemic progressed: an observational study of mortality to 60 days after admission to a 15-hospital US health system

Inpatient Costs of Treating Patients With COVID-19

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