Racial Disparities in Potentially Avoidable Hospitalizations During the COVID-19 Pandemic.

Autor: Leuchter RK; Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California. Electronic address: rleuchter@mednet.ucla.edu., Villaflores CWA; Division of Geriatric Medicine, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California., Norris KC; Division of General Internal Medicine & Health Services Research, David Geffen School of Medicine, UCLA, Los Angeles, California., Sorensen A; Division of Geriatric Medicine, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California., Vangala S; Department of Medicine Statistics Core, David Geffen School of Medicine, UCLA, Los Angeles, California., Sarkisian CA; Division of Geriatric Medicine, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California; Greater Los Angeles VA Healthcare System Geriatrics Research Education and Clinical Center (GRECC), Los Angeles, California.
Jazyk: angličtina
Zdroj: American journal of preventive medicine [Am J Prev Med] 2021 Aug; Vol. 61 (2), pp. 235-239. Date of Electronic Publication: 2021 Mar 19.
DOI: 10.1016/j.amepre.2021.01.036
Abstrakt: Introduction: Potentially avoidable hospitalizations are disproportionately experienced by racial and ethnic minorities and expose these groups to unnecessary iatrogenic harm (including the risk of nosocomial COVID-19) and undue financial burden. In working toward an overarching goal of eliminating racial and ethnic health disparities, it is important to understand whether and to what extent potentially avoidable hospitalizations have changed by race and ethnicity during the COVID-19 pandemic.
Methods: This single-center pre-post study included patients admitted to any UCLA Health hospital for an ambulatory care-sensitive condition between March-August 2019 (prepandemic period) and March-August 2020 (postpandemic period). Investigators measured the change in the number of potentially avoidable hospitalizations (defined per the Agency for Healthcare Research and Quality guidelines) stratified by race and ethnicity and calculated the 95% CIs for these hospitalizations using a cluster bootstrap procedure.
Results: Between March 1, 2020 and August 31, 2020, 347 of 4,838 hospitalizations (7.2%) were potentially avoidable, compared with 557 of 6,248 (8.9%) during the same 6-month period in 2019. Potentially avoidable hospitalizations decreased by 50.3% (95% CI=41.2, 60.9) among non-Hispanic Whites but only by 8.0% (95% CI= -16.2, 39.9) among African Americans (50.3% vs 8.0%, p=0.015).
Conclusions: Racial disparities in potentially avoidable hospitalizations increased during the COVID-19 pandemic at a large urban health system. Given that the prepandemic rates of potentially avoidable hospitalizations were already higher among racial and ethnic minorities, especially among African Americans, this finding should cause alarm and lead to further exploration of the complex factors contributing to these disparities.
(Copyright © 2021. Published by Elsevier Inc.)
Databáze: MEDLINE
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