Social determinants of health predict readmission following COVID-19 hospitalization: a health information exchange-based retrospective cohort study
IntroductionSince February 2020, over 104 million people in the United States have been diagnosed with SARS-CoV-2 infection, or COVID-19, with over 8.5 million reported in the state of Texas. This study analyzed social determinants of health as predictors for readmission among COVID-19 patients in S...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-03-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1352240/full |
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| author | Micaela N. Sandoval Jennifer L. Mikhail Melyssa K. Fink Guillermo A. Tortolero Tru Cao Ryan Ramphul Junaid Husain Eric Boerwinkle |
| author_facet | Micaela N. Sandoval Jennifer L. Mikhail Melyssa K. Fink Guillermo A. Tortolero Tru Cao Ryan Ramphul Junaid Husain Eric Boerwinkle |
| author_sort | Micaela N. Sandoval |
| collection | DOAJ |
| description | IntroductionSince February 2020, over 104 million people in the United States have been diagnosed with SARS-CoV-2 infection, or COVID-19, with over 8.5 million reported in the state of Texas. This study analyzed social determinants of health as predictors for readmission among COVID-19 patients in Southeast Texas, United States.MethodsA retrospective cohort study was conducted investigating demographic and clinical risk factors for 30, 60, and 90-day readmission outcomes among adult patients with a COVID-19-associated inpatient hospitalization encounter within a regional health information exchange between February 1, 2020, to December 1, 2022.Results and discussionIn this cohort of 91,007 adult patients with a COVID-19-associated hospitalization, over 21% were readmitted to the hospital within 90 days (n = 19,679), and 13% were readmitted within 30 days (n = 11,912). In logistic regression analyses, Hispanic and non-Hispanic Asian patients were less likely to be readmitted within 90 days (adjusted odds ratio [aOR]: 0.8, 95% confidence interval [CI]: 0.7–0.9, and aOR: 0.8, 95% CI: 0.8–0.8), while non-Hispanic Black patients were more likely to be readmitted (aOR: 1.1, 95% CI: 1.0–1.1, p = 0.002), compared to non-Hispanic White patients. Area deprivation index displayed a clear dose–response relationship to readmission: patients living in the most disadvantaged neighborhoods were more likely to be readmitted within 30 (aOR: 1.1, 95% CI: 1.0–1.2), 60 (aOR: 1.1, 95% CI: 1.2–1.2), and 90 days (aOR: 1.2, 95% CI: 1.1–1.2), compared to patients from the least disadvantaged neighborhoods. Our findings demonstrate the lasting impact of COVID-19, especially among members of marginalized communities, and the increasing burden of COVID-19 morbidity on the healthcare system. |
| first_indexed | 2024-04-24T18:48:06Z |
| format | Article |
| id | doaj.art-0ef6ab40f6b74bf79cecb59805e4cd22 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-24T18:48:06Z |
| publishDate | 2024-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-0ef6ab40f6b74bf79cecb59805e4cd222024-03-27T04:37:50ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-03-011210.3389/fpubh.2024.13522401352240Social determinants of health predict readmission following COVID-19 hospitalization: a health information exchange-based retrospective cohort studyMicaela N. Sandoval0Jennifer L. Mikhail1Melyssa K. Fink2Guillermo A. Tortolero3Tru Cao4Ryan Ramphul5Junaid Husain6Eric Boerwinkle7Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United StatesGreater Houston HealthConnect, Houston, TX, United StatesGreater Houston HealthConnect, Houston, TX, United StatesDepartment of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United StatesDepartment of Biostatistics and Data Science, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United StatesDepartment of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United StatesGreater Houston HealthConnect, Houston, TX, United StatesDepartment of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United StatesIntroductionSince February 2020, over 104 million people in the United States have been diagnosed with SARS-CoV-2 infection, or COVID-19, with over 8.5 million reported in the state of Texas. This study analyzed social determinants of health as predictors for readmission among COVID-19 patients in Southeast Texas, United States.MethodsA retrospective cohort study was conducted investigating demographic and clinical risk factors for 30, 60, and 90-day readmission outcomes among adult patients with a COVID-19-associated inpatient hospitalization encounter within a regional health information exchange between February 1, 2020, to December 1, 2022.Results and discussionIn this cohort of 91,007 adult patients with a COVID-19-associated hospitalization, over 21% were readmitted to the hospital within 90 days (n = 19,679), and 13% were readmitted within 30 days (n = 11,912). In logistic regression analyses, Hispanic and non-Hispanic Asian patients were less likely to be readmitted within 90 days (adjusted odds ratio [aOR]: 0.8, 95% confidence interval [CI]: 0.7–0.9, and aOR: 0.8, 95% CI: 0.8–0.8), while non-Hispanic Black patients were more likely to be readmitted (aOR: 1.1, 95% CI: 1.0–1.1, p = 0.002), compared to non-Hispanic White patients. Area deprivation index displayed a clear dose–response relationship to readmission: patients living in the most disadvantaged neighborhoods were more likely to be readmitted within 30 (aOR: 1.1, 95% CI: 1.0–1.2), 60 (aOR: 1.1, 95% CI: 1.2–1.2), and 90 days (aOR: 1.2, 95% CI: 1.1–1.2), compared to patients from the least disadvantaged neighborhoods. Our findings demonstrate the lasting impact of COVID-19, especially among members of marginalized communities, and the increasing burden of COVID-19 morbidity on the healthcare system.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1352240/fullCOVID-19social determinants of healthepidemiologyclinical outcomesinfectious diseasehealthcare utilization |
| spellingShingle | Micaela N. Sandoval Jennifer L. Mikhail Melyssa K. Fink Guillermo A. Tortolero Tru Cao Ryan Ramphul Junaid Husain Eric Boerwinkle Social determinants of health predict readmission following COVID-19 hospitalization: a health information exchange-based retrospective cohort study Frontiers in Public Health COVID-19 social determinants of health epidemiology clinical outcomes infectious disease healthcare utilization |
| title | Social determinants of health predict readmission following COVID-19 hospitalization: a health information exchange-based retrospective cohort study |
| title_full | Social determinants of health predict readmission following COVID-19 hospitalization: a health information exchange-based retrospective cohort study |
| title_fullStr | Social determinants of health predict readmission following COVID-19 hospitalization: a health information exchange-based retrospective cohort study |
| title_full_unstemmed | Social determinants of health predict readmission following COVID-19 hospitalization: a health information exchange-based retrospective cohort study |
| title_short | Social determinants of health predict readmission following COVID-19 hospitalization: a health information exchange-based retrospective cohort study |
| title_sort | social determinants of health predict readmission following covid 19 hospitalization a health information exchange based retrospective cohort study |
| topic | COVID-19 social determinants of health epidemiology clinical outcomes infectious disease healthcare utilization |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1352240/full |
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