Racial Disparities in 30-Day Outcomes Following Index Admission for COVID-19

Frontiers in Medicine

Anne Marie McCarthy¹  Lauren Pantalone²  Tessa Cook²  Despina Kontos²  Erica L. Carpenter³  Jeffrey C. Thompson⁴  Vivek Nimgaonkar⁵ 

[1] Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States;Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States;Division of Hematology-Oncology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States;Division of Pulmonary, Allergy, and Critical Care Medicine, Thoracic Oncology Group, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States;Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States;

关键词: readmission;    COVID-19;    racial disparity;    comorbidity;    post-acute care;   

DOI  :  10.3389/fmed.2021.750650

来源: DOAJ

【 摘 要 】

We investigated racial disparities in a 30-day composite outcome of readmission and death among patients admitted across a 5-hospital health system following an index COVID-19 admission. A dataset of 1,174 patients admitted between March 1, 2020 and August 21, 2020 for COVID-19 was retrospectively analyzed for odds of readmission among Black patients compared to all other patients, with sequential adjustment for demographics, index admission characteristics, type of post-acute care, and comorbidities. Tabulated results demonstrated a significantly greater odds of 30-day readmission or death among Black patients (18.0% of Black patients vs. 11.3% of all other patients; Univariate Odds Ratio: 1.71, p = 0.002). Sequential adjustment via logistic regression revealed that the odds of 30-day readmission or death were significantly greater among Black patients after adjustment for demographics, index admission characteristics, and type of post-acute care, but not comorbidities. Stratification by type of post-acute care received on discharge revealed that the same disparity in odds of 30-day readmission or death existed among patients discharged home without home services, but not those discharged to home with home services or to a skilled nursing facility or acute rehab facility. Collectively, the findings suggest that weighing comorbidity burdens in post-acute care decisions may be relevant in addressing racial disparities in 30-day outcomes following discharge from an index COVID-19 admission.

【 授权许可】

Unknown