Panagis Galiatsatos, MD, MHS, and Souvik Chatterjee, MD, are Assistant Professors and Edward S. Chen, MD, is an Associate Professor, Division of Pulmonary and Critical Care Medicine; Kathleen R. Page, MD, is an Associate Professor, Division of Infectious Diseases; Felicia Hill-Briggs, PhD, is a Professor, Division of General Internal Medicine; and Sherita H. Golden, MD, MHS, is a Professor, Division of Endocrinology, Diabetes, and Metabolism; all in the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Panagis Galiatsatos and Felicia Hill-Briggs are Co-Chairs, Johns Hopkins Health Equity Steering Committee; April Lugo is a Program Specialist; and Sherita H. Golden is Director; all in the Office of Diversity, Inclusion, and Health Equity, Johns Hopkins Medicine, Baltimore, MD. Sherita H. Golden is also Lead, Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, MD. Panagis Galiatsatos is Co-Director, Medicine for the Greater Good; and Joyce Maygers, DNP, RN, is a Senior Clinical Outcomes Coordinator, Department of Care Management; both at Johns Hopkins Bayview Medical Center, Baltimore, MD. Sauradeep Sarker, MD, is an Internal Medicine Resident, Department of Medicine, Sinai Hospital, Baltimore, MD. Vanya Jones, PhD, is an Associate Professor, Health, Behavior, and Society; Felicia Hill-Briggs and Sherita H. Golden are Professors of Medicine, Welch Center for Prevention, Epidemiology, and Clinical Research; and Sherita H. Golden is a Professor, Department of Epidemiology; all at the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Tina Tolson, RN, is Director, Johns Hopkins Medicine Language Services, Johns Hopkins Health System, Baltimore, MD.
Health Secur. 2021 Jun;19(S1):S34-S40. doi: 10.1089/hs.2021.0049. Epub 2021 Apr 30.
In the context of the COVID-19 pandemic, reassessing intensive care unit (ICU) use by population should be a priority for hospitals planning for critical care resource allocation. In our study, we reviewed the impact of COVID-19 on a community hospital serving an urban region, comparing the sociodemographic distribution of ICU admissions before and during the pandemic. We executed a time-sensitive analysis to see if COVID-19 ICU admissions reflect the regional sociodemographic populations and ICU admission trends before the pandemic. Sociodemographic variables included sex, race, ethnicity, and age of adult patients (ages 18 years and older) admitted to the hospital's medical and cardiac ICUs, which were converted to COVID-19 ICUs. The time period selected was 18 months, which was then dichotomized into pre-COVID-19 admissions (December 1, 2018 to March 13, 2020) and COVID-19 ICU admissions (March 14 to May 31, 2020). Variables were compared using Fisher's exact tests and Wilcoxon tests when appropriate. During the 18-month period, 1,861 patients were admitted to the aforementioned ICUs. The mean age of the patients was 62.75 (SD 15.57), with the majority of these patients being male (52.23%), White (64.43%), and non-Hispanic/Latinx (95.75%). Differences were found in racial and ethnic distribution comparing pre-COVID-19 admissions to COVID-19 admissions. Compared with pre-COVID-19 ICU admissions, we found an increase in African American versus White admissions ( = .01) and an increase in Hispanic/Latinx versus non-Hispanic/Latinx admissions ( < .01), during the COVID-19 pandemic. During the first 3 months of admissions to COVID-19 ICUs, the number of admissions among Hispanic/Latinx and African American patients increased while the number of admissions among non-Hispanic/Latinx and White patient decreased, compared with the pre-COVID-19 period. These findings support development of strategies to enhance allocation of resources to bolster novel, equitable strategies to mitigate the incidence of COVID-19 in urban populations.
在 COVID-19 大流行的背景下，医院在规划重症监护资源配置时，应优先重新评估按人群划分的重症监护病房（ICU）使用情况。在我们的研究中，我们回顾了一家服务于城市地区的社区医院所受到的 COVID-19 影响，并比较了大流行前后 ICU 入院患者的社会人口统计学分布。我们进行了一项时间敏感的分析，以观察 COVID-19 ICU 入院是否反映了大流行前该地区的社会人口统计学人群和 ICU 入院趋势。社会人口统计学变量包括性别、种族、族裔和入住医院内科和心脏 ICU 的成年患者（18 岁及以上）的年龄，这些 ICU 后来被转换为 COVID-19 ICU。选择的时间段为 18 个月，然后将其分为 COVID-19 前入院（2018 年 12 月 1 日至 2020 年 3 月 13 日）和 COVID-19 ICU 入院（2020 年 3 月 14 日至 5 月 31 日）。使用 Fisher 精确检验和 Wilcoxon 检验比较变量，在适当情况下使用。在 18 个月期间，有 1861 名患者入住上述 ICU。患者的平均年龄为 62.75（标准差 15.57），其中大多数患者为男性（52.23%）、白人（64.43%）和非西班牙裔/拉丁裔（95.75%）。与 COVID-19 前入院相比，种族和族裔分布存在差异。与 COVID-19 前 ICU 入院相比，我们发现非裔美国人与白人入院的比例增加（ = .01），西班牙裔/拉丁裔与非西班牙裔/拉丁裔入院的比例增加（ < .01），在 COVID-19 大流行期间。在 COVID-19 ICU 入院的头 3 个月，与 COVID-19 前时期相比，西班牙裔/拉丁裔和非裔美国人患者的入院人数增加，而非西班牙裔/拉丁裔和白人患者的入院人数减少。这些发现支持制定战略，以加强资源分配，以支持新颖、公平的战略，以减轻城市人口中 COVID-19 的发病率。
