Racial and Regional Disparities Surrounding In-Hospital Mortality among Patients with 2019 Novel Coronavirus Disease (COVID-19): Evidence from NIS Sample in 2020.

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Racial and Ethnic Health Disparities Pub Date : 2024-08-01 Epub Date: 2023-07-07 DOI:10.1007/s40615-023-01707-1

Sun Jung Kim, Mar Medina, Jeong-Hui Park, Jongwha Chang

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Abstract

Objective: This study explores differences in COVID-19 in-hospital mortality rates by patient and geographic factors to identify at-risk populations and analyze how strained health disparities were exacerbated during the pandemic.

Methods: The latest 2020 United States National Inpatient Sample (NIS) data was used to obtain a population-based estimate for patients with COVID-19. We conducted a cross-sectional retrospective data analysis, and sampling weights were used for all statistical analyses to represent nationwide in-hospital mortality of patients with COVID-19. We used multivariate logistic regression models to identify predictors for how patients with COVID-19 are associated with in-hospital death.

Results: Of 200,531 patients, 88.9% did not have an in-hospital death (n=178,369), and 11.1% had in-hospital death (n=22,162). Patients older than 70 were 10 times more likely to have an in-hospital death than patients younger than 40 (p<0.001). Male patients were 37% more likely to have an in-hospital death than female patients (p<0.001). Hispanic patients were 25% more likely to have in-hospital deaths than White patients (p<0.001). In the sub-analysis, Hispanic patients in the 50-60, 60-70, and 70 age groups were 32%, 34%, and 24%, respectively, more likely to have in-hospital death than White patients (p<0.001). Patients with hypertension and diabetes were 69% and 29%, respectively, more likely to have in-hospital death than patients without hypertension and diabetes.

Conclusion: Health disparities in the COVID-19 pandemic occurred across races and regions and must be addressed to prevent future deaths. Age and comorbidities like diabetes have a well-established link to increased disease severity, and we have linked both to higher mortality risk. Low-income patients had a significantly increased risk of in-hospital death starting at over 40 years old.

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2019年新型冠状病毒病（COVID-19）患者住院死亡率的种族和地区差异：来自 2020 年 NIS 样本的证据。

目标：本研究根据患者和地域因素探讨 COVID-19 住院死亡率的差异，以确定高危人群并分析大流行期间紧张的健康差异是如何加剧的：方法：我们使用最新的 2020 年美国全国住院病人抽样 (NIS) 数据对 COVID-19 患者进行了基于人群的估计。我们进行了横断面回顾性数据分析，并在所有统计分析中使用抽样权重来代表 COVID-19 患者的全国院内死亡率。我们使用多变量逻辑回归模型来确定 COVID-19 患者与院内死亡的相关预测因素：在200,531名患者中，88.9%没有发生院内死亡（n=178,369），11.1%发生院内死亡（n=22,162）。70岁以上的患者发生院内死亡的几率是40岁以下患者的10倍（p结论：在 COVID-19 大流行中，不同种族和地区之间存在着健康差异，必须加以解决，以防止未来死亡事件的发生。年龄和糖尿病等并发症与疾病严重程度的增加有着公认的联系，我们已将这两者与较高的死亡风险联系起来。低收入患者的院内死亡风险从 40 岁以上开始明显增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Racial and Ethnic Health Disparities PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

7.30

自引率

5.10%

发文量

263

期刊介绍： Journal of Racial and Ethnic Health Disparities reports on the scholarly progress of work to understand, address, and ultimately eliminate health disparities based on race and ethnicity. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. Promising studies that are ongoing or studies that have longer term data are welcome, as are studies that serve as lessons for best practices in eliminating health disparities. Original research, systematic reviews, and commentaries presenting the state-of-the-art thinking on problems centered on health disparities will be considered for publication. We particularly encourage review articles that generate innovative and testable ideas, and constructive discussions and/or critiques of health disparities.Because the Journal of Racial and Ethnic Health Disparities receives a large number of submissions, about 30% of submissions to the Journal are sent out for full peer review.