TY - JOUR
T1 - Variations in COVID-19 Hospital Mortality by Patient Race/Ethnicity and Hospital Type in Illinois
AU - Hua, Miao Jenny
AU - Feinglass, Joe
N1 - Funding Information:
We thank William Trick, MD of Cook County Health for his valuable comments on an earlier version of this article.
Publisher Copyright:
© 2022, W. Montague Cobb-NMA Health Institute.
PY - 2023/4
Y1 - 2023/4
N2 - Background and Objectives: It is controversial whether hospital care mitigated or exacerbated population level racial and ethnic disparities in COVID-19 mortality. To begin answering that question, this study analyzed variations in COVID-19 hospital mortality in Illinois by patient race and ethnicity and by hospital characteristics, while providing an estimate of hospital-level variation in COVID-19 mortality. Method: This is a retrospective cohort study based on hospital administrative data for adult patients with COVID-19 discharged from acute care, non-federal Illinois hospitals from April 1, 2020 through June 30, 2021. The association of patient and hospital characteristics with the likelihood of death was analyzed using multilevel logistic regression. Results: There were 158,569 COVID-19-coded admissions to 181 general hospitals in Illinois; 14.5% resulted in death or discharge to hospice. Hospital deaths accounted for nearly 90% of all COVID-19-associated deaths over 15 months in Illinois. After adjusting for patient- and hospital-level characteristics, Hispanic patients had higher mortality risk (aOR 1.26, 95% CI: 1.20–1.33) as compared with non-Hispanic White patients, while non-Hispanic Black patients had lower mortality risk (aOR 0.75, 95% CI: 0.71–0.79). Safety net hospitals receiving disproportionate share hospital (DSH) funds had higher mortality risk (aOR 1.81, 95% CI: 1.43–2.30) compared with other hospitals. Conclusion: Risk-adjusted COVID-19 hospital mortality was highest among patients of Hispanic ethnicity, while non-Hispanic Black patients had lower risk than non-Hispanic White patients. There was significant variation in hospital mortality rates, with particularly high safety net hospital mortality.
AB - Background and Objectives: It is controversial whether hospital care mitigated or exacerbated population level racial and ethnic disparities in COVID-19 mortality. To begin answering that question, this study analyzed variations in COVID-19 hospital mortality in Illinois by patient race and ethnicity and by hospital characteristics, while providing an estimate of hospital-level variation in COVID-19 mortality. Method: This is a retrospective cohort study based on hospital administrative data for adult patients with COVID-19 discharged from acute care, non-federal Illinois hospitals from April 1, 2020 through June 30, 2021. The association of patient and hospital characteristics with the likelihood of death was analyzed using multilevel logistic regression. Results: There were 158,569 COVID-19-coded admissions to 181 general hospitals in Illinois; 14.5% resulted in death or discharge to hospice. Hospital deaths accounted for nearly 90% of all COVID-19-associated deaths over 15 months in Illinois. After adjusting for patient- and hospital-level characteristics, Hispanic patients had higher mortality risk (aOR 1.26, 95% CI: 1.20–1.33) as compared with non-Hispanic White patients, while non-Hispanic Black patients had lower mortality risk (aOR 0.75, 95% CI: 0.71–0.79). Safety net hospitals receiving disproportionate share hospital (DSH) funds had higher mortality risk (aOR 1.81, 95% CI: 1.43–2.30) compared with other hospitals. Conclusion: Risk-adjusted COVID-19 hospital mortality was highest among patients of Hispanic ethnicity, while non-Hispanic Black patients had lower risk than non-Hispanic White patients. There was significant variation in hospital mortality rates, with particularly high safety net hospital mortality.
KW - COVID-19
KW - Epidemiology
KW - Social determinants of health
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U2 - 10.1007/s40615-022-01279-6
DO - 10.1007/s40615-022-01279-6
M3 - Article
C2 - 35257313
AN - SCOPUS:85125753580
SN - 2197-3792
VL - 10
SP - 911
EP - 919
JO - Journal of Racial and Ethnic Health Disparities
JF - Journal of Racial and Ethnic Health Disparities
IS - 2
ER -