Equity evaluation of intensive care unit admission based on comorbidity in hospitalized patients with COVID-19: a cross-sectional analysis

Autor: Yang-Jie Zhu, Jia-Yue Wang, Chen-Nan Wu, Bo-Yang Yu, Tong-Tong Liu, Yuan Liu, Lu-Lu Zhang
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Frontiers in Public Health, Vol 12 (2024)
Druh dokumentu: article
ISSN: 2296-2565
DOI: 10.3389/fpubh.2024.1430462
Popis: BackgroundIntensive care unit (ICU) beds played a crucial role in reducing mortality rates of patients with severe COVID-19. The surge in the number of patients led to a shortage of ICU beds, which may have exacerbated inequity of healthcare utilization. However, most attention has been focused on the horizontal equity in healthcare utilization, where individuals with the same needs receive the same services. Vertical equity, where individuals with higher needs receive more healthcare is often neglected, which might overestimate the equity. This study analyzes the vertical equity of ICU utilization among hospitalized patients with COVID-19.MethodsIn total, 18,547 hospitalized patients with COVID-19 in Maryland in 2020 were enrolled in this cross-sectional study. Logistic regression analysis was conducted to determine the independent factors affecting ICU utilization, and the Shapley value decomposition approach was implemented to assess the contribution of the independent variables to disparities in ICU admission. A concentration curve and concentration index were used to assess the vertical equity in healthcare utilization.ResultsICU utilization by patients with COVID-19 was significantly affected by Charlson Comorbidity Index (CCI), with odds ratios (OR) 1.09 [95% confidence intervals (CI): 1.07–1.10; p
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