Association of healthcare access with intensive care unit utilization and mortality in patients of hispanic ethnicity hospitalized with COVID-19

Ferdinand Velasco, Donghan M. Yang, Minzhe Zhang, Tanna Nelson, Thomas Sheffield, Tony Keller, Yiqing Wang, Clark Walker, Chaitanya Katterapalli, Kelli Zimmerman, Andrew Masica, Christoph U. Lehmann, Yang Xie, John W. Hollingsworth

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

BACKGROUND: Racial and ethnic minority groups in the United States experience a disproportionate burden of COVID-19 deaths. OBJECTIVE: To evaluate whether outcome differences between Hispanic and non-Hispanic COVID-19 hospitalized patients exist and, if so, to identify the main malleable contributing factors. DESIGN, SETTING, PARTICIPANTS: Retrospective, cross-sectional, observational study of 6097 adult COVID-19 patients hospitalized within a single large healthcare system from March to November 2020. EXPOSURES: Self-reported ethnicity and primary language. MAIN OUTCOMES AND MEASURES: Clinical outcomes included intensive care unit (ICU) utilization and in-hospital death. We used age-adjusted odds ratios (OR) and multivariable analysis to evaluate the associations between ethnicity/language groups and outcomes. RESULTS: 32.1% of patients were Hispanic, 38.6% of whom reported a non-English primary language. Hispanic patients were less likely to be insured, have a primary care provider, and have accessed the healthcare system prior to the COVID-19 admission. After adjusting for age, Hispanic inpatients experienced higher ICU utilization (non-English-speaking: OR, 1.75; 95% CI, 1.47-2.08; English-speaking: OR, 1.13; 95% CI, 0.95-1.33) and higher mortality (non-English-speaking: OR, 1.43; 95% CI, 1.10-1.86; English-speaking: OR, 1.53; 95% CI, 1.19-1.98) compared to non-Hispanic inpatients. There were no observed treatment disparities among ethnic groups. After adjusting for age, Hispanic inpatients had elevated disease severity at admission (non-English-speaking: OR, 2.27; 95% CI, 1.89-2.72; English-speaking: OR, 1.33; 95% CI, 1.10-1.61). In multivariable analysis, the associations between ethnicity/language and clinical outcomes decreased after considering baseline disease severity (P <.001). CONCLUSION: The associations between ethnicity and clinical outcomes can be explained by elevated disease severity at admission and limited access to healthcare for Hispanic patients, especially non-English-speaking Hispanics. Journal of Hospital Medicine 2021;16:659-666.

Original languageEnglish (US)
Pages (from-to)659-666
Number of pages8
JournalJournal of hospital medicine
Volume16
Issue number11
DOIs
StatePublished - Nov 2021

ASJC Scopus subject areas

  • Internal Medicine
  • Leadership and Management
  • Fundamentals and skills
  • Health Policy
  • Care Planning
  • Assessment and Diagnosis

Fingerprint

Dive into the research topics of 'Association of healthcare access with intensive care unit utilization and mortality in patients of hispanic ethnicity hospitalized with COVID-19'. Together they form a unique fingerprint.

Cite this