Diversification of COVID-19 Testing Resources to Decrease Racial/Ethnic Disparities: Comparative Use of Adaptive Approaches to Community Testing Across an Integrated Healthcare System.
Diversification of COVID-19 Testing Resources to Decrease Racial/Ethnic Disparities: Comparative Use of Adaptive Approaches to Community Testing Across an Integrated Healthcare System.
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DOI：
10.1016/j.dialog.2022.100017
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发表时间：
2022-12
期刊：
影响因子：
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通讯作者：
McCurdy, Lewis
中科院分区：
文献类型：
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作者：
Priem, Jennifer S;Krinner, Lisa M;Constantine, S Tyler;McCurdy, Lewis
背景：获得 SARS-CoV-2 检测是早期识别和疾病遏制的重要组成部分。检测利用方面存在种族和民族健康差异。为了利用有限的资源优化检测，Atrium Health 在传统临床环境之外开发了独立的流动检测中心，希望满足多元化城市社区的需求。本研究的目的是根据人口统计因素，特别是种族/民族，评估测试场地利用率的差异。方法：对 Atrium Health 系统内于 2020 年 3 月 10 日至 10 月 26 日期间接受过 COVID-19 检测的患者进行的队列研究。结果：我们的卫生系统对 128,258 名受调查者 (PUI) 进行了检测，其中包括我们的移动综合医疗（以前称为社区辅助医疗）免下车检测点和社区巡回检测单位的 25,434 名患者。 PUI 的平均年龄为 47 岁 (SD = 17.7)；大约一半是女性和白人/白人。非西班牙裔白人和非裔美国人使用得来速测试点的比例较高，而西班牙裔 PUI 使用率较低。年轻的 PUI、西班牙裔和其他种族/族裔的 PUI 使用流动测试单位的比例明显更高。结论：检测地点的多样化优化了检测资源，显着减轻了患者数量的负担，并避免了我们紧急护理设施和急诊科工作流程的改变。此外，巡回检测单位可能有助于减少获得 COVID-19 检测的种族/民族差异。我们的结果强调了提供多种测试方式以覆盖不同人群的重要性。
Background: Access to SARS-CoV-2 testing is a crucial component of early identification and disease containment. Racial and ethnic health disparities exist related to testing utilization. To optimize testing with limited resources, Atrium Health developed free-standing and roving testing centers outside of the traditional clinical settings in hopes of meeting the needs of a diverse urban community. The objective of this study is to evaluate differences in testing site utilization based on demographic factors, particularly race/ethnicity. Methods:A cohort study of patients tested for COVID-19 between March 10 and October 26, 2020, within the Atrium Health system. Results: 128,258 persons under investigation (PUIs) were tested across our health system, including 25,434 patients at our Mobile Integrated Health (previously called Community Paramedicine) drive-thru testing sites and community roving testing units. PUIs were on average 47 years old (SD = 17.7); approximately half were female and White/Caucasian. Drive-thru testing sites were utilized proportionally more by non-Hispanic Whites and African Americans, and less by Hispanic PUIs. Roving testing units were used significantly more by younger PUIs, Hispanics, and PUIs of other races/ethnicities. Conclusions: Diversification in testing site locations optimized testing resources, allowed for significant reduction in the burden of patient volumes, and avoided alteration of workflow in our urgent care facilities and Emergency Departments. Additionally, roving testing units may help to decrease racial/ethnic disparities in access to COVID-19 testing. Our results highlight the importance of offering a variety of testing modalities to reach different populations.