From the Department of Medicine and the Rollins School of Public Health, Emory University, Atlanta, Georgia.
South Med J. 2022 Dec;115(12):913-918. doi: 10.14423/SMJ.0000000000001487.
The aim of this study was to assess the association between race and ethnicity and admission to intermediate (IMCUs) or intensive care units (ICUs) among hospitalized patients.
Using Florida hospital discharge data from the Agency for Healthcare Research and Quality-sponsored State Inpatient Database in 2017, we assessed the relationship between race (White, Black, Other) and Hispanic ethnicity and IMCU or ICU admission. Demographic covariates included age, sex, quartile of household income for patient ZIP code, insurance status, and patient residence. An adjusted model assessed the association between race and ethnicity and IMCU or ICU admission using log binomial regression with generalized estimating equations after controlling for demographic characteristics and the Elixhauser Comorbidity Index.
After controlling for demographics and comorbidities, the prevalence of IMCU or ICU admission was higher among non-Hispanic Blacks (adjusted prevalence ratio [aPR] 1.04; 95% confidence interval [CI] 1.02-1.05) and non-Hispanic patients of other races (aPR 1.03; 95% CI 1.01-1.04) compared with non-Hispanic Whites. The prevalence of IMCU or ICU use was lower among Hispanic Whites (aPR 0.98; 95% CI 0.86-1.00) and Hispanics of other races (aPR 0.96; 95% CI 0.95-0.98) compared with non-Hispanic Whites after controlling for other demographic characteristics and comorbidities.
Among hospitalized patients, racial minorities are slightly more likely to use higher levels of care, whereas Hispanic patients are generally slightly less likely than non-Hispanic White patients to use higher levels of care. Further evaluation is needed to identify reasons for disparate IMCU or ICU admission.
本研究旨在评估种族和民族与住院患者入住中级（IMCU）或重症监护病房（ICU）之间的关联。
利用 2017 年美国医疗保健研究与质量机构赞助的州住院患者数据库中的佛罗里达医院出院数据，我们评估了种族（白人、黑人、其他）和西班牙裔与 IMCU 或 ICU 入院之间的关系。人口统计学协变量包括年龄、性别、患者邮政编码所在家庭收入的四分位数、保险状况和患者居住地。调整模型使用对数二项式回归和广义估计方程，在控制人口统计学特征和 Elixhauser 合并症指数后，评估种族和民族与 IMCU 或 ICU 入院之间的关联。
在控制人口统计学和合并症后，非西班牙裔黑人（调整后的患病率比 [aPR] 1.04；95%置信区间 [CI] 1.02-1.05）和非西班牙裔其他种族患者（aPR 1.03；95% CI 1.01-1.04）的 IMCU 或 ICU 入院率高于非西班牙裔白人。与非西班牙裔白人相比，西班牙裔白人（aPR 0.98；95% CI 0.86-1.00）和其他种族的西班牙裔（aPR 0.96；95% CI 0.95-0.98）的 IMCU 或 ICU 使用率较低，在控制其他人口统计学特征和合并症后。
在住院患者中，少数族裔患者使用更高水平的护理的可能性略高，而西班牙裔患者使用更高水平的护理的可能性通常略低于非西班牙裔白人患者。需要进一步评估以确定 ICU 或 ICU 入住率差异的原因。
