News: Study finds racial and ethnic in-hospital mortality disparities during pandemic

A study published in the Journal of the American Medical Association (JAMA) Health Forum looked at Medicare beneficiaries during the coronavirus pandemic, finding racial and ethnic disparities in mortality in COVID-19 hospitalizations. Additionally, mortality disparities widened in non-COVID-19 hospitalizations, HealthLeaders reported.

The recent study is based on an analysis of fee-for-service Medicare inpatient data for more than 31 million beneficiaries and more than 14 million hospitalizations from January 2019 through February 2021.

The study features several key data points:

• Although in-hospital COVID-19 mortality was similar for Black and white patients, it was 3.5% higher for Hispanic and other minority patients  
  • Unadjusted in-hospital mortality for COVID-19 hospitalizations was 16.6% for white patients, 17.0% for Black patients, 21.7% for Hispanic patients, and 21.0% for other racial and ethnic minority patients
     
• COVID-19 hospitalizations for white patients through February 2021 were 1.4 per 1,000 beneficiaries per month
  • COVID-19 hospitalizations for Black and Hispanic patients through February 2021 were 2.8 and 3.6 per 1,000 beneficiaries per month, respectively
     
• In adjusted analyses, in-hospital mortality for non-COVID-19 Black patients increased 0.48% more than it increased for non-COVID-19 white patients
   
  • Non-COVID-19 hospitalizations for white patients decreased from 17.9 per 1,000 beneficiaries per month before the pandemic to 13.4 per 1,000 beneficiaries per month through February 2021, representing a 25% decrease
     
  • Non-COVID-19 hospitalizations for Black, Hispanic, and other racial and ethnic minority patients through February 2021 decreased 22.9%, 30.6%, and 26.4%, respectively
     

"Among COVID-19 and non–COVID-19 hospitalizations, racial and ethnic disparities in mortality were evident. As the pandemic evolves, efforts to understand the sources of pandemic-associated disparities and to improve health equity are needed," the study's co-authors wrote.

The data shows three primary changes in hospital care linked to the pandemic, the study's co-authors wrote.

• Non-COVID-19 hospitalizations decreased sharply for all racial and ethnic groups, which is in line with other research that has shown decreased healthcare utilization during the pandemic.
   
• Hispanic and other racial and ethnic minority patients experienced higher COVID-19 in-hospital mortality than white patients.
   
• There were racial and ethnic disparities in non-COVID-19 in-hospital mortality during the pandemic. For example, Black patients experienced a nearly 0.5% differential increase in in-hospital mortality compared to white patients.

Editor’s note: This article was originally published by HealthLeaders. Additional ADIS coverage of health disparities can be found here.