Disparities In Outcomes Among COVID-19 Patients In A Large Health Care System In California
Disparities In Outcomes Among COVID-19 Patients In A Large Health Care System In California
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DOI：
10.1377/hlthaff.2020.00598
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发表时间：
2020-07-01
期刊：
影响因子：
9.7
通讯作者：
Pressman, Alice R.
中科院分区：
文献类型：
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作者：
Azar, Kristen M. J.;Shen, Zijun;Pressman, Alice R.
随着新型冠状病毒疾病(COVID 19)大流行在美国各地蔓延，越来越多的证据表明，种族和族裔少数群体以及社会经济弱势群体正在承受不成比例的疾病和死亡负担。我们对萨特健康公司的新冠肺炎患者进行了回顾性队列分析，以衡量潜在的差异。萨特健康公司是加州北部的一家大型综合医疗系统。我们使用Sutter的集成电子健康记录来识别疑似和确诊为新冠肺炎的成年人，并使用多变量Logistic回归来评估住院风险，调整了已知的风险因素，如种族/民族、性别、年龄、健康和社会经济变量。我们分析了2020年1月1日至4月8日期间1,052例新冠肺炎确诊病例。在我们的研究结果中，我们观察到，与非西班牙裔白人患者相比，经过年龄、性别、合并症和收入调整后，非西班牙裔非裔美国人患者的住院几率是后者的2.7倍。我们探讨了可能的解释，包括社会因素，这些因素要么导致及时获得护理的障碍，要么造成患者认为推迟护理是最明智的选择。我们的研究为新冠肺炎的呈现提供了种族和民族差异的真实证据。
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, nonHispanic 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.