Medical care · 2026
Preventable Differences in Recommended Outpatient COVID-19 Treatment Among Adults With COVID-19 in the United States.
СтатьяНазвание и аннотация: Перевод в очереди
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Bournigal-Feliciano Mariela, Graff Nathan, Koumans Emilia H, Shah Melisa M, Woolfork Makhabele N, Lunsford Natasha B, King Hope, Patel Pragna, Hagen Melissa B, Kappelman Michael D, Mayer Kenneth H, Thacker Deepika, Arnold Jonathan, Carton Thomas W, Draper Christine, Emerton Diane, Block Jason, Manns Brian J, PCORnet Network Partners
Аннотация
BACKGROUND: The COVID-19 pandemic exposed differences in health care outcomes, including the prescription of COVID-19 antiviral medications. This analysis aimed to describe prescribing patterns in outpatient COVID-19 treatment and assess factors that contributed to these differences.
METHODS: A cross-sectional analysis was conducted using electronic health record data from August 2022 through March 2024 from health care institutions participating in PCORnet,® the National Patient-Centered Clinical Research Network. Descriptive statistics were used to characterize COVID-19 outpatients eligible for treatment, and regression models were used to calculate adjusted prevalence ratios (aPR) of prescribed COVID-19 outpatient treatment. Interaction terms assessed the interactions between race and ethnicity and the combined comorbidity index (CCI), age and sex, and age and race and ethnicity.
RESULTS: Of 1,247,420 patients eligible for COVID-19 treatment, 334,947 (26.9%) were prescribed outpatient treatment. In adjusted analyses, compared with White patients, all other racial and ethnic groups had lower aPR for treatment (aPRs:0.89-0.99), except patients who reported being multiracial (aPR:1.00; 95% CI: 0.93-1.08). Those aged 65-74 were prescribed treatment more often (aPR: 1.13; 95% CI: 1.12-1.13) compared with patients aged 20-49. Patients with a CCI of 1-3 and ≥4 were prescribed treatment less often (aPR: 0.99, 95% CI: 0.97-1.01 and aPR: 0.91, 95% CI: 0.89-0.94, respectively), compared with those with a CCI of ≤0. These differences were sustained when considering the interactions between race and age and race and CCI.
CONCLUSIONS: We found differences in recommended outpatient treatment by several sociodemographic variables. Addressing COVID-19 prescription barriers is essential to slow preventable differences from unmet COVID-19 outpatient care.
METHODS: A cross-sectional analysis was conducted using electronic health record data from August 2022 through March 2024 from health care institutions participating in PCORnet,® the National Patient-Centered Clinical Research Network. Descriptive statistics were used to characterize COVID-19 outpatients eligible for treatment, and regression models were used to calculate adjusted prevalence ratios (aPR) of prescribed COVID-19 outpatient treatment. Interaction terms assessed the interactions between race and ethnicity and the combined comorbidity index (CCI), age and sex, and age and race and ethnicity.
RESULTS: Of 1,247,420 patients eligible for COVID-19 treatment, 334,947 (26.9%) were prescribed outpatient treatment. In adjusted analyses, compared with White patients, all other racial and ethnic groups had lower aPR for treatment (aPRs:0.89-0.99), except patients who reported being multiracial (aPR:1.00; 95% CI: 0.93-1.08). Those aged 65-74 were prescribed treatment more often (aPR: 1.13; 95% CI: 1.12-1.13) compared with patients aged 20-49. Patients with a CCI of 1-3 and ≥4 were prescribed treatment less often (aPR: 0.99, 95% CI: 0.97-1.01 and aPR: 0.91, 95% CI: 0.89-0.94, respectively), compared with those with a CCI of ≤0. These differences were sustained when considering the interactions between race and age and race and CCI.
CONCLUSIONS: We found differences in recommended outpatient treatment by several sociodemographic variables. Addressing COVID-19 prescription barriers is essential to slow preventable differences from unmet COVID-19 outpatient care.