{"doi":"10.12788/jhm.3717","title":"Association of Healthcare Access With Intensive Care Unit Utilization and Mortality in Patients of Hispanic Ethnicity Hospitalized With COVID‐19","abstract":"BACKGROUND: Racial and ethnic minority groups in the United States experience a disproportionate burden of COVID-19 deaths. OBJECTIVE: To evaluate whether outcome differences between Hispanic and non-Hispanic COVID-19 hospitalized patients exist and, if so, to identify the main malleable contributing factors. DESIGN, SETTING, PARTICIPANTS: Retrospective, cross-sectional, observational study of 6097 adult COVID-19 patients hospitalized within a single large healthcare system from March to November 2020. EXPOSURES: Self-reported ethnicity and primary language. MAIN OUTCOMES AND MEASURES: Clinical outcomes included intensive care unit (ICU) utilization and in-hospital death. We used age-adjusted odds ratios (OR) and multivariable analysis to evaluate the associations between ethnicity/language groups and outcomes. RESULTS: 32.1% of patients were Hispanic, 38.6% of whom reported a non-English primary language. Hispanic patients were less likely to be insured, have a primary care provider, and have accessed the healthcare system prior to the COVID-19 admission. After adjusting for age, Hispanic inpatients experienced higher ICU utilization (non-English-speaking: OR, 1.75; 95% CI, 1.47-2.08; English-speaking: OR, 1.13; 95% CI, 0.95-1.33) and higher mortality (non-English-speaking: OR, 1.43; 95% CI, 1.10-1.86; English-speaking: OR, 1.53; 95% CI, 1.19-1.98) compared to non-Hispanic inpatients. There were no observed treatment disparities among ethnic groups. After adjusting for age, Hispanic inpatients had elevated disease severity at admission (non-English-speaking: OR, 2.27; 95% CI, 1.89-2.72; English-speaking: OR, 1.33; 95% CI, 1.10- 1.61). In multivariable analysis, the associations between ethnicity/language and clinical outcomes decreased after considering baseline disease severity (P < .001). CONCLUSION: The associations between ethnicity and clinical outcomes can be explained by elevated disease severity at admission and limited access to healthcare for Hispanic patients, especially non-English-speaking Hispanics.","journal":"Journal of Hospital Medicine","year":2021,"id":170413,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":28,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9423,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":342413,"name":"Donghan M. Yang","orcid":"0000-0003-1935-0214","position":1,"is_corresponding":false},{"id":352533,"name":"Minzhe Zhang","orcid":"0000-0002-4555-1928","position":2,"is_corresponding":false},{"id":704068,"name":"Tanna L. Nelson","orcid":null,"position":3,"is_corresponding":false},{"id":352534,"name":"Thomas Sheffield","orcid":"0000-0001-9073-6334","position":4,"is_corresponding":false},{"id":704069,"name":"Tony Keller","orcid":null,"position":5,"is_corresponding":false},{"id":703179,"name":"Yiqing Wang","orcid":"0000-0003-3994-6517","position":6,"is_corresponding":false},{"id":704070,"name":"Clark Walker","orcid":null,"position":7,"is_corresponding":false},{"id":704071,"name":"Chaitanya Katterapalli","orcid":null,"position":8,"is_corresponding":false},{"id":704072,"name":"Kelli Zimmerman","orcid":null,"position":9,"is_corresponding":false},{"id":703180,"name":"Andrew L. Masica","orcid":"0000-0003-2566-3444","position":10,"is_corresponding":false},{"id":703181,"name":"Christoph U. Lehmann","orcid":"0000-0001-9559-4646","position":11,"is_corresponding":false},{"id":326811,"name":"Yang Xie","orcid":"0000-0001-9456-1762","position":12,"is_corresponding":false},{"id":293685,"name":"John W. Hollingsworth","orcid":null,"position":13,"is_corresponding":false},{"id":704067,"name":"Ferdinand Velasco","orcid":null,"position":0,"is_corresponding":true}],"reference_count":27,"raw_metadata":null,"created_at":"2026-07-18T23:46:24.040760Z","pmid":"34730508","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}