Racial and Geographic Disparities in Interhospital ICU Transfers.
Crit Care Med
; 46(1): e76-e80, 2018 01.
Article
em En
| MEDLINE
| ID: mdl-29068859
ABSTRACT
OBJECTIVES:
Interhospital transfer, a common intervention, may be subject to healthcare disparities. In mechanically ventilated patients with sepsis, we hypothesize that disparities not disease related would be found between patients who were and were not transferred.DESIGN:
Retrospective cohort study.SETTING:
Nationwide Inpatient Sample, 2006-2012. PATIENTS Patients over 18 years old with a primary diagnosis of sepsis who underwent mechanical ventilation.INTERVENTIONS:
None. MEASUREMENTS AND MAINRESULTS:
We obtained age, gender, length of stay, race, insurance coverage, do not resuscitate status, and Elixhauser comorbidities. The outcome used was interhospital transfer from a small- or medium-sized hospital to a larger acute care hospital. Of 55,208,382 hospitalizations, 46,406 patients met inclusion criteria. In the multivariate model, patients were less likely to be transferred if the following were present older age (odds ratio, 0.98; 95% CI, 0.978-0.982), black race (odds ratio, 0.79; 95% CI, 0.70-0.89), Hispanic race (odds ratio, 0.79; 95% CI, 0.69-0.90), South region hospital (odds ratio, 0.79; 95% CI, 0.72-0.88), teaching hospital (odds ratio, 0.31; 95% CI, 0.28-0.33), and do not resuscitate status (odds ratio, 0.19; 95% CI, 0.15-0.25).CONCLUSIONS:
In mechanically ventilated patients with sepsis, we found significant disparities in race and geographic location not explained by medical diagnoses or illness severity.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Respiração Artificial
/
Transferência de Pacientes
/
Sepse
/
Disparidades em Assistência à Saúde
/
Racismo
/
Unidades de Terapia Intensiva
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article