Title: Addressing ethnic disparities in imaging utilization and clinical outcomes for COVID-19
Country: United States
Age: Adult Only
Sex: All Sexes
Care Setting: Inpatient and Outpatient
Clinical Setting: Chest Pain Imaging
Data Level: Single Institution
Data Type: EHR
Data Source: Local data
Conclusion: No Disparities Based on Patient Race/Ethnicity
Health OutComes Reported: Yes
Free Text Conclusion: No statistically significant differences in the utilization of CXRs or clinical outcomes between Hispanics and non-Hispanics.
Abstract: PURPOSE: Racial and ethnic disparities have exacerbated during the COVID-19 pandemic as the healthcare system is overwhelmed. While Hispanics are disproportionately affected by COVID-19, little is known about ethnic disparities in the hospital settings. This study investigates imaging utilization and clinical outcomes between Hispanic and non-Hispanic COVID-19 patients in the Emergency Department (ED) and during hospitalization. METHODS: Through retrospective chart review, we included 331 symptomatic COVID-19 patients (mean age 53.2 years) at a metropolitan healthcare system from March to June 2020. Poisson regression was used to compare diagnostic imaging utilization and clinical outcomes between Hispanic and non-Hispanic patients. RESULTS: After adjusting for confounders, no statistically significant difference was found between Hispanic and non-Hispanic patients for the number of weekly chest X-rays. Results were categorized into four clinical outcomes: ED management (0.16 0.05 vs. 0.14 0.8, p: 0.79); requiring inpatient management (1.31 0.11 vs. 1.46 0.16, p: 0.43); ICU admission without invasive ventilation (1.4 0.17 vs. 1.35 0.26, p: 0.86); and ICU admission and ventilator support (3.29 0.22 vs. 3.59 0.37, p: 0.38). There were no statistically significant relative differences in adjusted prevalence rate between ethnic groups for all clinical outcomes (p > 0.05). There was a statistically significant longer adjusted length of stay (days) in non-Hispanics for two subcohorts: inpatient management (8.16 0.31 vs. 9.72 0.5, p < 0.01) and ICU admission without invasive ventilation (10.39 0.57 vs. 13.45 1.13, p < 0.01). CONCLUSIONS: For Hispanic and non-Hispanic COVID-19 patients in the ED or hospitalized, there were no statistically significant differences in imaging utilization and clinical outcomes.