The Association between Patient Insurance Status and COVID-19 ICU Admission

Presenter Biography

Alex Shonk is a second-year MPH Epidemiology student, and will graduate summer of 2023. She works for the Winthrop Research Group in the School of Public health on infectious disease clinical trials.

Institution

OHSU

Program/Major

Epidemiology

Degree

MPH

Presentation Type

Poster

Start Date

4-4-2023 2:00 PM

End Date

4-4-2023 3:00 PM

Persistent Identifier

https://archives.pdx.edu/ds/psu/40210

Keywords

Structural determinants of health, COVID-19, Medicare, Medicaid, Insurance

Abstract

Introduction: Research has expanded over the last half a century on the impact that structural determinants of health (SDoH) have on patient outcomes. The COVID-19 pandemic exacerbated the disparities that patients face due to SDoH, and assessing the influence that these factors have on negative patient outcomes provides evidence to support policy change. The relationship that a patient’s insurance status has on their outcomes from a COVID-19 hospital admission is worth assessing in order to pursue equitable insurance coverage for patients. Methods: The study population (n = 227) included symptomatic patients over 18 who were admitted to Oregon Health and Science University be April 15, 2020, and June 30, 2021. Patients were included if they had a positive SARS-CoV-2 PCR test up to ten days prior to admission and were not missing data on exposure or outcome variables. The exposure variable was patient insurance status, categorized into private insurance (referent) and public insurance. The outcome variable was ICU admission during COVID-19 hospitalization. Multivariable logistic models were used to estimate the crude and adjusted odds ratios and their 95% confidence intervals for the association between patient insurance status and ICU admission. Results: After adjusting for confounders, the odds of being admitted to the ICU during COVID-19 hospitalization were 1.41 (95% CI: 0.73, 2.73) times higher for patients with public insurance patients than for patients with private insurance. Conclusion: Patients with public insurance are at higher risk for negative COVid-19 outcomes during hospitalization.

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Apr 4th, 2:00 PM Apr 4th, 3:00 PM

The Association between Patient Insurance Status and COVID-19 ICU Admission

Introduction: Research has expanded over the last half a century on the impact that structural determinants of health (SDoH) have on patient outcomes. The COVID-19 pandemic exacerbated the disparities that patients face due to SDoH, and assessing the influence that these factors have on negative patient outcomes provides evidence to support policy change. The relationship that a patient’s insurance status has on their outcomes from a COVID-19 hospital admission is worth assessing in order to pursue equitable insurance coverage for patients. Methods: The study population (n = 227) included symptomatic patients over 18 who were admitted to Oregon Health and Science University be April 15, 2020, and June 30, 2021. Patients were included if they had a positive SARS-CoV-2 PCR test up to ten days prior to admission and were not missing data on exposure or outcome variables. The exposure variable was patient insurance status, categorized into private insurance (referent) and public insurance. The outcome variable was ICU admission during COVID-19 hospitalization. Multivariable logistic models were used to estimate the crude and adjusted odds ratios and their 95% confidence intervals for the association between patient insurance status and ICU admission. Results: After adjusting for confounders, the odds of being admitted to the ICU during COVID-19 hospitalization were 1.41 (95% CI: 0.73, 2.73) times higher for patients with public insurance patients than for patients with private insurance. Conclusion: Patients with public insurance are at higher risk for negative COVid-19 outcomes during hospitalization.