McCrohan Megan, Nierenberg Linnea, Karabon Patrick, Wunderlich-Barillas Tracy, Halalau Alexandra
Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
Office of Research, Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
Int J Gen Med. 2021 Nov 3;14:7681-7686. doi: 10.2147/IJGM.S328663. eCollection 2021.
The COVID-19 pandemic continues to impact the health-care system in the United States and has brought further light on health disparities within it. However, only a few studies have examined hospitalization risk with regard to social determinants of health.
We aimed to identify how health disparities affect hospitalization rates among patients with COVID-19.
This observational study included all individuals diagnosed with COVID-19 from February 25, 2020 to December 31, 2020. Uni- and multivariate analyses were utilized to evaluate associations between demographic data and inpatient versus outpatient status for patients with COVID-19.
Multicenter (8 hospitals), largest size health system in Southeast Michigan, a region highly impacted by the pandemic.
All outpatients and inpatients with a positive RT-PCR for SARS-CoV-2 on nasopharyngeal swab were included. Exclusion criteria included missing demographic data or status as a non-permanent Michigan resident.
Patients who met inclusion and exclusion criteria were divided in 2 groups: outpatients and inpatients.
We described the comparative demographics and known disparities associated with hospitalization status.
Of 30,292 individuals who tested positive for SARS-CoV-2, 34.01% were admitted to the hospital. White or Caucasian race was most prevalent (57.49%), and 23.35% were African-American. The most common ethnicity was non-Hispanic or Latino (70.48%). English was the primary language for the majority of patients (91.60%). Private insurance holders made up 71.11% of the sample. Within the hospitalized patients, lower socioeconomic status, African-American race and Hispanic and Latino ethnicity, non-English speaking status, and Medicare and Medicaid were more likely to be admitted to the hospital.
Several health disparities were associated with greater rates of hospitalization due to COVID-19. Addressing these inequalities from an individual to system level may improve health-care outcomes for those with health disparities and COVID-19.
2019冠状病毒病（COVID-19）大流行继续影响着美国的医疗保健系统，并进一步凸显了其中的健康差异。然而，只有少数研究探讨了与健康社会决定因素相关的住院风险。
我们旨在确定健康差异如何影响COVID-19患者的住院率。
这项观察性研究纳入了2020年2月25日至2020年12月31日期间所有确诊为COVID-19的个体。采用单变量和多变量分析来评估COVID-19患者人口统计学数据与住院和门诊状态之间的关联。
多中心（8家医院），密歇根州东南部最大规模的医疗系统，该地区受疫情影响严重。
所有鼻咽拭子SARS-CoV-2反转录聚合酶链反应（RT-PCR）检测呈阳性的门诊和住院患者均被纳入。排除标准包括人口统计学数据缺失或非密歇根州常住居民身份。
符合纳入和排除标准的患者分为两组：门诊患者和住院患者。
我们描述了与住院状态相关的比较人口统计学和已知差异。
在30292名SARS-CoV-2检测呈阳性的个体中，34.01%被收治入院。白人或高加索人种最为普遍（57.49%），非裔美国人占23.35%。最常见的种族是非西班牙裔或拉丁裔（70.48%）。大多数患者的主要语言是英语（91.60%）。私人保险持有者占样本的71.11%。在住院患者中，社会经济地位较低、非裔美国人种族、西班牙裔和拉丁裔种族、非英语使用者身份以及医疗保险和医疗补助的参保者更有可能入院。
由于COVID-19，一些健康差异与更高的住院率相关。从个体到系统层面解决这些不平等问题可能会改善存在健康差异的COVID-19患者的医疗保健结局。
