Evaluating racial/ethnic differences in care escalation among COVID-19 patients in a home-based hospital

TL Liu, SH Chou, S Murphy, M Kowalkowski… - Journal of Racial and …, 2023 - Springer
TL Liu, SH Chou, S Murphy, M Kowalkowski, YJ Taylor, C Hole, K Sitammagari, JS Priem…
Journal of Racial and Ethnic Health Disparities, 2023Springer
The novel coronavirus disease 2019 (COVID-19) has infected over 414 million people
worldwide with 5.8 million deaths, as of February 2022. Telemedicine-based interventions to
expand healthcare systems' capacity and reduce infection risk have rapidly increased during
the pandemic, despite concerns regarding equitable access. Atrium Health Hospital at
Home (AH-HaH) is a home-based program that provides advanced, hospital-level medical
care and monitoring for patients who would otherwise be hospitalized in a traditional setting …
Abstract
The novel coronavirus disease 2019 (COVID-19) has infected over 414 million people worldwide with 5.8 million deaths, as of February 2022. Telemedicine-based interventions to expand healthcare systems’ capacity and reduce infection risk have rapidly increased during the pandemic, despite concerns regarding equitable access. Atrium Health Hospital at Home (AH-HaH) is a home-based program that provides advanced, hospital-level medical care and monitoring for patients who would otherwise be hospitalized in a traditional setting. Our retrospective cohort study of positive COVID-19 patients who were admitted to AH-HaH aims to investigate whether the rate of care escalation from AH-HaH to traditional hospitalization differed based on patients’ racial/ethnic backgrounds. Logistic regression was used to examine the association between care escalation within 14 days from index AH-HaH admission and race/ethnicity. We found approximately one in five patients receiving care for COVID-19 in AH-HaH required care escalation within 14 days. Odds of care escalation were not significantly different for Hispanic or non-Hispanic Blacks compared to non-Hispanic Whites. However, secondary analyses showed that both Hispanic and non-Hispanic Black patients were younger and with fewer comorbidities than non-Hispanic Whites. The study highlights the need for new care models to vigilantly monitor for disparities, so that timely and tailored adaptations can be implemented for vulnerable populations.
Springer
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