Racial, Ethnic, and Social Disparities in Emergency Department Outcomes of COVID-19 Patients in New York City
Name: Ryan Carson
School: Vagelos College of Physicians and Surgeons, Class of 2023
Mentor: Tsion Firew, MD, MPH
Abstract
Since the World Health Organization declared COVID-19 a pandemic, the number of cases and deaths has risen at an unprecedented rate. Early reports suggested that rates of hospitalization and deaths were increased among Black and Hispanic Americans with additional geographic disparities across the boroughs of New York City. Further research is still needed to understand these results and their causes. This study aimed to investigate whether outcomes of patients with COVID-19 in three Columbia University Emergency Departments between March 1st and May 1st 2020 differed as a function of race/ethnicity, insurance status, income level, or primary language spoken. The primary outcome of interest was in-hospital mortality. Secondary outcomes include hospital and emergency department length of stay as well as emergency department disposition to floor versus ICU areas. Clinical data and outcomes were extracted from the electronic medical record for 2297 patients and compared across groups using log binomial models for statistical analysis. Preliminary results show that racial/ethnic minorities have a lower risk of mortality in early periods after entering the emergency department, but their risk becomes similar to non-Hispanic whites over time. Medicare patients had a greater risk of mortality relative to Medicaid patients. No difference in risk of mortality between Medicaid, commercial, and other patients was observed. These results help illuminate the experience of patients with COVID-19 and suggest that disparities in outcomes may not be entirely driven by their experiences in the hospital.