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美国 COVID 治疗和住院时间的种族不平等随时间变化。

Racial inequality in COVID-treatment and in-hospital length of stay in the US over time.

机构信息

Truveta, Inc., Bellevue, WA, United States.

Information School, University of Washington, Seattle, WA, United States.

出版信息

Front Public Health. 2023 Jan 11;10:1074775. doi: 10.3389/fpubh.2022.1074775. eCollection 2022.

Abstract

INTRODUCTION

Demonstrated health inequalities persist in the United States. SARS-CoV-2 (COVID) has been no exception, with access to treatment and hospitalization differing across race or ethnic groups. Here, we aim to assess differences in treatment with remdesivir and hospital length of stay across the four waves of the pandemic.

MATERIALS AND METHODS

Using a subset of the Truveta data, we examine the odds ratio (OR) of in-hospital remdesivir treatment and risk ratio (RR) of in-hospital length of stay between Black or African American (Black) to White patients. We adjusted for confounding factors, such as age, sex, and comorbidity status.

RESULTS

There were statistically significant lower rates of remdesivir treatment and longer in-hospital length of stay comparing Black patients to White patients early in the pandemic (OR for treatment: 0.88, 95% confidence interval [CI]: 0.80, 0.96; RR for length of stay: 1.17, CI: 1.06, 1.21). Rates became close to parity between groups as the pandemic progressed.

CONCLUSION

While inpatient remdesivir treatment rates increased and length of stay decreased over the beginning course of the pandemic, there are still inequalities in patient care.

摘要

简介

在美国,明显存在健康不平等现象。SARS-CoV-2(COVID)也不例外,不同种族或族裔群体在治疗和住院方面存在差异。在这里,我们旨在评估在大流行的四个阶段中,使用瑞德西韦治疗和住院时间长短方面的差异。

材料和方法

我们使用 Truveta 数据的一个子集,检查住院期间接受瑞德西韦治疗的比值比(OR)和住院时间长短的风险比(RR),比较黑人和非洲裔美国人(黑人)与白人患者之间的差异。我们调整了年龄、性别和合并症状态等混杂因素。

结果

在大流行早期,与白人患者相比,黑人患者接受瑞德西韦治疗的比率和住院时间明显更长(治疗的 OR:0.88,95%置信区间 [CI]:0.80,0.96;住院时间的 RR:1.17,CI:1.06,1.21)。随着大流行的进展,两组之间的比率变得接近均等。

结论

尽管在大流行开始时,住院患者接受瑞德西韦治疗的比率增加,住院时间缩短,但患者护理方面仍存在不平等现象。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4dd9/9876573/6195657a1379/fpubh-10-1074775-g0001.jpg

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