Variations in COVID-19 Hospital Mortality by Patient Race/Ethnicity and Hospital Type in Illinois.
COVID-19
Epidemiology
Social determinants of health
Journal
Journal of racial and ethnic health disparities
ISSN: 2196-8837
Titre abrégé: J Racial Ethn Health Disparities
Pays: Switzerland
ID NLM: 101628476
Informations de publication
Date de publication:
04 2023
04 2023
Historique:
received:
24
01
2022
accepted:
28
02
2022
revised:
25
02
2022
pubmed:
9
3
2022
medline:
9
3
2023
entrez:
8
3
2022
Statut:
ppublish
Résumé
It is controversial whether hospital care mitigated or exacerbated population level racial and ethnic disparities in COVID-19 mortality. To begin answering that question, this study analyzed variations in COVID-19 hospital mortality in Illinois by patient race and ethnicity and by hospital characteristics, while providing an estimate of hospital-level variation in COVID-19 mortality. This is a retrospective cohort study based on hospital administrative data for adult patients with COVID-19 discharged from acute care, non-federal Illinois hospitals from April 1, 2020 through June 30, 2021. The association of patient and hospital characteristics with the likelihood of death was analyzed using multilevel logistic regression. There were 158,569 COVID-19-coded admissions to 181 general hospitals in Illinois; 14.5% resulted in death or discharge to hospice. Hospital deaths accounted for nearly 90% of all COVID-19-associated deaths over 15 months in Illinois. After adjusting for patient- and hospital-level characteristics, Hispanic patients had higher mortality risk (aOR 1.26, 95% CI: 1.20-1.33) as compared with non-Hispanic White patients, while non-Hispanic Black patients had lower mortality risk (aOR 0.75, 95% CI: 0.71-0.79). Safety net hospitals receiving disproportionate share hospital (DSH) funds had higher mortality risk (aOR 1.81, 95% CI: 1.43-2.30) compared with other hospitals. Risk-adjusted COVID-19 hospital mortality was highest among patients of Hispanic ethnicity, while non-Hispanic Black patients had lower risk than non-Hispanic White patients. There was significant variation in hospital mortality rates, with particularly high safety net hospital mortality.
Sections du résumé
BACKGROUND AND OBJECTIVES
It is controversial whether hospital care mitigated or exacerbated population level racial and ethnic disparities in COVID-19 mortality. To begin answering that question, this study analyzed variations in COVID-19 hospital mortality in Illinois by patient race and ethnicity and by hospital characteristics, while providing an estimate of hospital-level variation in COVID-19 mortality.
METHOD
This is a retrospective cohort study based on hospital administrative data for adult patients with COVID-19 discharged from acute care, non-federal Illinois hospitals from April 1, 2020 through June 30, 2021. The association of patient and hospital characteristics with the likelihood of death was analyzed using multilevel logistic regression.
RESULTS
There were 158,569 COVID-19-coded admissions to 181 general hospitals in Illinois; 14.5% resulted in death or discharge to hospice. Hospital deaths accounted for nearly 90% of all COVID-19-associated deaths over 15 months in Illinois. After adjusting for patient- and hospital-level characteristics, Hispanic patients had higher mortality risk (aOR 1.26, 95% CI: 1.20-1.33) as compared with non-Hispanic White patients, while non-Hispanic Black patients had lower mortality risk (aOR 0.75, 95% CI: 0.71-0.79). Safety net hospitals receiving disproportionate share hospital (DSH) funds had higher mortality risk (aOR 1.81, 95% CI: 1.43-2.30) compared with other hospitals.
CONCLUSION
Risk-adjusted COVID-19 hospital mortality was highest among patients of Hispanic ethnicity, while non-Hispanic Black patients had lower risk than non-Hispanic White patients. There was significant variation in hospital mortality rates, with particularly high safety net hospital mortality.
Identifiants
pubmed: 35257313
doi: 10.1007/s40615-022-01279-6
pii: 10.1007/s40615-022-01279-6
pmc: PMC8900642
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
911-919Informations de copyright
© 2022. W. Montague Cobb-NMA Health Institute.
Références
JAMA Netw Open. 2021 May 3;4(5):e218828
pubmed: 33938933
JAMA Netw Open. 2020 Dec 1;3(12):e2026881
pubmed: 33275153
Med Care Res Rev. 2009 Oct;66(5):590-605
pubmed: 19398722
Am J Public Health. 2021 Jul;111(S2):S101-S106
pubmed: 34314208
J Racial Ethn Health Disparities. 2021 Oct;8(5):1161-1167
pubmed: 32946070
BMC Med Res Methodol. 2012 Mar 12;12:28
pubmed: 22409732
MMWR Morb Mortal Wkly Rep. 2021 Aug 20;70(33):1114-1119
pubmed: 34411075
JAMA Netw Open. 2021 Jun 1;4(6):e2112842
pubmed: 34137829
MMWR Morb Mortal Wkly Rep. 2020 May 08;69(18):545-550
pubmed: 32379729
JAMA Netw Open. 2021 Nov 1;4(11):e2135967
pubmed: 34812846
N Engl J Med. 2020 Jun 25;382(26):2534-2543
pubmed: 32459916
JAMA Health Forum. 2021 Dec 23;2(12):e214223
pubmed: 35977303
Arch Intern Med. 2007 Jun 25;167(12):1233-9
pubmed: 17592095
JAMA Netw Open. 2020 Aug 03;3(8):e2018039
pubmed: 32809033
JAMA. 2020 May 26;323(20):2052-2059
pubmed: 32320003
Health Aff (Millwood). 2020 Jul;39(7):1253-1262
pubmed: 32437224
Ethn Dis. 2021 Jul 15;31(3):389-398
pubmed: 34295125
Am J Obstet Gynecol. 2016 Aug;215(2):143-52
pubmed: 27179441
J Public Health Manag Pract. 2021 Jan/Feb;27 Suppl 1, COVID-19 and Public Health: Looking Back, Moving For:S43-S56
pubmed: 32956299
J Gen Intern Med. 2021 May;36(5):1302-1309
pubmed: 33506402
Am J Respir Crit Care Med. 2021 Apr 23;204(403-411):
pubmed: 33891529
Ann Epidemiol. 2021 Jun;58:124-127
pubmed: 33771693
J Clin Epidemiol. 2004 Dec;57(12):1288-94
pubmed: 15617955
JAMA Netw Open. 2018 Sep 7;1(5):e182044
pubmed: 30646146