Racial and Ethnic Disparities in Acute Care Utilization Among Patients With Glomerular Disease
Copyright © 2022 National Kidney Foundation, Inc. All rights reserved..
RATIONALE & OBJECTIVE: The effects of race, ethnicity, socioeconomic status (SES), and disease severity on acute care utilization in patients with glomerular disease are unknown.
STUDY DESIGN: Prospective cohort study.
SETTING & PARTICIPANTS: 1,456 adults and 768 children with biopsy-proven glomerular disease enrolled in the Cure Glomerulonephropathy (CureGN) cohort.
EXPOSURE: Race and ethnicity as a participant-reported social factor.
OUTCOME: Acute care utilization defined as hospitalizations or emergency department visits.
ANALYTICAL APPROACH: Multivariable recurrent event proportional rate models were used to estimate associations between race and ethnicity and acute care utilization.
RESULTS: Black or Hispanic participants had lower SES and more severe glomerular disease than White or Asian participants. Acute care utilization rates were 45.6, 29.5, 25.8, and 19.2 per 100 person-years in Black, Hispanic, White, and Asian adults, respectively, and 55.8, 42.5, 40.8, and 13.0, respectively, for children. Compared with the White race (reference group), Black race was significantly associated with acute care utilization in adults (rate ratio [RR], 1.76 [95% CI, 1.37-2.27]), although this finding was attenuated after multivariable adjustment (RR, 1.31 [95% CI, 1.03-1.68]). Black race was not significantly associated with acute care utilization in children; Asian race was significantly associated with lower acute care utilization in children (RR, 0.32 [95% CI 0.14-0.70]); no significant associations between Hispanic ethnicity and acute care utilization were identified.
LIMITATIONS: We used proxies for SES and lacked direct information on income, household unemployment, or disability.
CONCLUSIONS: Significant differences in acute care utilization rates were observed across racial and ethnic groups in persons with prevalent glomerular disease, although many of these difference were explained by differences in SES and disease severity. Measures to combat socioeconomic disadvantage in Black patients and to more effectively prevent and treat glomerular disease are needed to reduce disparities in acute care utilization, improve patient wellbeing, and reduce health care costs.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:81 |
|---|---|
| Enthalten in: |
American journal of kidney diseases : the official journal of the National Kidney Foundation - 81(2023), 3 vom: 01. März, Seite 318-328.e1 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Krissberg, Jill R [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 27.02.2023 Date Revised 02.03.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1053/j.ajkd.2022.08.010 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM347071945 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM347071945 | ||
| 003 | DE-627 | ||
| 005 | 20240302231948.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1053/j.ajkd.2022.08.010 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1314.xml |
| 035 | |a (DE-627)NLM347071945 | ||
| 035 | |a (NLM)36191724 | ||
| 035 | |a (PII)S0272-6386(22)00919-2 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Krissberg, Jill R |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Racial and Ethnic Disparities in Acute Care Utilization Among Patients With Glomerular Disease |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 27.02.2023 | ||
| 500 | |a Date Revised 02.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 National Kidney Foundation, Inc. All rights reserved. | ||
| 520 | |a RATIONALE & OBJECTIVE: The effects of race, ethnicity, socioeconomic status (SES), and disease severity on acute care utilization in patients with glomerular disease are unknown | ||
| 520 | |a STUDY DESIGN: Prospective cohort study | ||
| 520 | |a SETTING & PARTICIPANTS: 1,456 adults and 768 children with biopsy-proven glomerular disease enrolled in the Cure Glomerulonephropathy (CureGN) cohort | ||
| 520 | |a EXPOSURE: Race and ethnicity as a participant-reported social factor | ||
| 520 | |a OUTCOME: Acute care utilization defined as hospitalizations or emergency department visits | ||
| 520 | |a ANALYTICAL APPROACH: Multivariable recurrent event proportional rate models were used to estimate associations between race and ethnicity and acute care utilization | ||
| 520 | |a RESULTS: Black or Hispanic participants had lower SES and more severe glomerular disease than White or Asian participants. Acute care utilization rates were 45.6, 29.5, 25.8, and 19.2 per 100 person-years in Black, Hispanic, White, and Asian adults, respectively, and 55.8, 42.5, 40.8, and 13.0, respectively, for children. Compared with the White race (reference group), Black race was significantly associated with acute care utilization in adults (rate ratio [RR], 1.76 [95% CI, 1.37-2.27]), although this finding was attenuated after multivariable adjustment (RR, 1.31 [95% CI, 1.03-1.68]). Black race was not significantly associated with acute care utilization in children; Asian race was significantly associated with lower acute care utilization in children (RR, 0.32 [95% CI 0.14-0.70]); no significant associations between Hispanic ethnicity and acute care utilization were identified | ||
| 520 | |a LIMITATIONS: We used proxies for SES and lacked direct information on income, household unemployment, or disability | ||
| 520 | |a CONCLUSIONS: Significant differences in acute care utilization rates were observed across racial and ethnic groups in persons with prevalent glomerular disease, although many of these difference were explained by differences in SES and disease severity. Measures to combat socioeconomic disadvantage in Black patients and to more effectively prevent and treat glomerular disease are needed to reduce disparities in acute care utilization, improve patient wellbeing, and reduce health care costs | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a ED visit | |
| 650 | 4 | |a Glomerular disease | |
| 650 | 4 | |a acute care utilization (ACU) | |
| 650 | 4 | |a adults | |
| 650 | 4 | |a children | |
| 650 | 4 | |a emergency department (ED) | |
| 650 | 4 | |a health care disparity | |
| 650 | 4 | |a hospitalization | |
| 650 | 4 | |a modifiable risk factor | |
| 650 | 4 | |a pediatric | |
| 650 | 4 | |a racial and ethnic disparities | |
| 650 | 4 | |a social determinants of health (SDOH) | |
| 650 | 4 | |a socioeconomic status (SES) | |
| 700 | 1 | |a O'Shaughnessy, Michelle M |e verfasserin |4 aut | |
| 700 | 1 | |a Smith, Abigail R |e verfasserin |4 aut | |
| 700 | 1 | |a Helmuth, Margaret E |e verfasserin |4 aut | |
| 700 | 1 | |a Almaani, Salem |e verfasserin |4 aut | |
| 700 | 1 | |a Aviles, Diego H |e verfasserin |4 aut | |
| 700 | 1 | |a Brathwaite, Kaye E |e verfasserin |4 aut | |
| 700 | 1 | |a Cai, Yi |e verfasserin |4 aut | |
| 700 | 1 | |a Cattran, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Gbadegesin, Rasheed |e verfasserin |4 aut | |
| 700 | 1 | |a Glenn, Dorey A |e verfasserin |4 aut | |
| 700 | 1 | |a Greenbaum, Larry A |e verfasserin |4 aut | |
| 700 | 1 | |a Iragorri, Sandra |e verfasserin |4 aut | |
| 700 | 1 | |a Jain, Koyal |e verfasserin |4 aut | |
| 700 | 1 | |a Khalid, Myda |e verfasserin |4 aut | |
| 700 | 1 | |a Kidd, Jason |e verfasserin |4 aut | |
| 700 | 1 | |a Kopp, Jeffrey |e verfasserin |4 aut | |
| 700 | 1 | |a Lafayette, Richard |e verfasserin |4 aut | |
| 700 | 1 | |a Lane, Jerome C |e verfasserin |4 aut | |
| 700 | 1 | |a Lugani, Francesca |e verfasserin |4 aut | |
| 700 | 1 | |a Nestor, Jordan G |e verfasserin |4 aut | |
| 700 | 1 | |a Parekh, Rulan S |e verfasserin |4 aut | |
| 700 | 1 | |a Reidy, Kimberly |e verfasserin |4 aut | |
| 700 | 1 | |a Selewski, David T |e verfasserin |4 aut | |
| 700 | 1 | |a Sethna, Christine B |e verfasserin |4 aut | |
| 700 | 1 | |a Sperati, C John |e verfasserin |4 aut | |
| 700 | 1 | |a Tuttle, Katherine |e verfasserin |4 aut | |
| 700 | 1 | |a Twombley, Katherine |e verfasserin |4 aut | |
| 700 | 1 | |a Vasylyeva, Tetyana L |e verfasserin |4 aut | |
| 700 | 1 | |a Weaver, Donald J |c Jr |e verfasserin |4 aut | |
| 700 | 1 | |a Wenderfer, Scott E |e verfasserin |4 aut | |
| 700 | 1 | |a Gibson, Keisha |e verfasserin |4 aut | |
| 700 | 0 | |a CureGN Consortium |e verfasserin |4 aut | |
| 700 | 1 | |a Ahn, Wooin |e investigator |4 oth | |
| 700 | 1 | |a Appel, Gerald |e investigator |4 oth | |
| 700 | 1 | |a Appelbaum, Paul |e investigator |4 oth | |
| 700 | 1 | |a Babayev, Revekka |e investigator |4 oth | |
| 700 | 1 | |a Bomback, Andrew |e investigator |4 oth | |
| 700 | 1 | |a Brown, Eric |e investigator |4 oth | |
| 700 | 1 | |a Canetta, Pietro |e investigator |4 oth | |
| 700 | 1 | |a Carlassara, Lucrezia |e investigator |4 oth | |
| 700 | 1 | |a Chan, Brenda |e investigator |4 oth | |
| 700 | 1 | |a D'Agati, Vivette Denise |e investigator |4 oth | |
| 700 | 1 | |a Dogra, Samitri |e investigator |4 oth | |
| 700 | 1 | |a Fernandez, Hilda |e investigator |4 oth | |
| 700 | 1 | |a Gharavi, Ali |e investigator |4 oth | |
| 700 | 1 | |a Hines, William |e investigator |4 oth | |
| 700 | 1 | |a Husain, Syed Ali |e investigator |4 oth | |
| 700 | 1 | |a Kiryluk, Krzysztof |e investigator |4 oth | |
| 700 | 1 | |a Lin, Fangming |e investigator |4 oth | |
| 700 | 1 | |a Marasa, Maddalena |e investigator |4 oth | |
| 700 | 1 | |a Markowitz, Glen |e investigator |4 oth | |
| 700 | 1 | |a Rasouly, Hila Milo |e investigator |4 oth | |
| 700 | 1 | |a Mohan, Sumit |e investigator |4 oth | |
| 700 | 1 | |a Mongera, Nicola |e investigator |4 oth | |
| 700 | 1 | |a Nickolas, Thomas |e investigator |4 oth | |
| 700 | 1 | |a Radhakrishnan, Jai |e investigator |4 oth | |
| 700 | 1 | |a Rao, Maya |e investigator |4 oth | |
| 700 | 1 | |a Sanna-Cherchi, Simone |e investigator |4 oth | |
| 700 | 1 | |a Shirazian, Shayan |e investigator |4 oth | |
| 700 | 1 | |a Stokes, Michael Barry |e investigator |4 oth | |
| 700 | 1 | |a Uy, Natalie |e investigator |4 oth | |
| 700 | 1 | |a Valeri, Anthony |e investigator |4 oth | |
| 700 | 1 | |a Vena, Natalie |e investigator |4 oth | |
| 700 | 1 | |a Foroncewicz, Bartosz |e investigator |4 oth | |
| 700 | 1 | |a Moszczuk, Barbara |e investigator |4 oth | |
| 700 | 1 | |a Mucha, Krzysztof |e investigator |4 oth | |
| 700 | 1 | |a Perkowska-Ptasińska, Agnieszka |e investigator |4 oth | |
| 700 | 1 | |a Ghiggeri, Gian Marco |e investigator |4 oth | |
| 700 | 1 | |a Ambruzs, Josephine |e investigator |4 oth | |
| 700 | 1 | |a Liapis, Helen |e investigator |4 oth | |
| 700 | 1 | |a Baracco, Rossana |e investigator |4 oth | |
| 700 | 1 | |a Jain, Amrish |e investigator |4 oth | |
| 700 | 1 | |a Ashoor, Isa |e investigator |4 oth | |
| 700 | 1 | |a Srivastava, Tarak |e investigator |4 oth | |
| 700 | 1 | |a Ahn, Sun-Young |e investigator |4 oth | |
| 700 | 1 | |a Devarajan, Prasad |e investigator |4 oth | |
| 700 | 1 | |a Erkan, Elif |e investigator |4 oth | |
| 700 | 1 | |a Claes, Donna |e investigator |4 oth | |
| 700 | 1 | |a Stone, Hillarey |e investigator |4 oth | |
| 700 | 1 | |a Mason, Sherene |e investigator |4 oth | |
| 700 | 1 | |a Silva, Cynthia |e investigator |4 oth | |
| 700 | 1 | |a Gomez-Mendez, Liliana |e investigator |4 oth | |
| 700 | 1 | |a Wang, Chia-Shi |e investigator |4 oth | |
| 700 | 1 | |a Yin, Hong Julie |e investigator |4 oth | |
| 700 | 1 | |a Jens, Goebel |e investigator |4 oth | |
| 700 | 1 | |a Steinke, Julia |e investigator |4 oth | |
| 700 | 1 | |a Cramer, Carl |e investigator |4 oth | |
| 700 | 1 | |a Pan, Cindy |e investigator |4 oth | |
| 700 | 1 | |a Sreedharan, Rajasree |e investigator |4 oth | |
| 700 | 1 | |a Bowers, Corinna |e investigator |4 oth | |
| 700 | 1 | |a Dreher, Mary |e investigator |4 oth | |
| 700 | 1 | |a Kallash, Mahmoud |e investigator |4 oth | |
| 700 | 1 | |a Mahan, John |e investigator |4 oth | |
| 700 | 1 | |a Sharpe, Samantha |e investigator |4 oth | |
| 700 | 1 | |a Smoyer, William |e investigator |4 oth | |
| 700 | 1 | |a Al-Uzri, Amira |e investigator |4 oth | |
| 700 | 1 | |a Belsha, Craig |e investigator |4 oth | |
| 700 | 1 | |a Braun, Michael |e investigator |4 oth | |
| 700 | 1 | |a Gomez, A C |e investigator |4 oth | |
| 700 | 1 | |a Feig, Daniel |e investigator |4 oth | |
| 700 | 1 | |a Fuentes, Gabriel Cara |e investigator |4 oth | |
| 700 | 1 | |a Hannah, Melisha |e investigator |4 oth | |
| 700 | 1 | |a Nester, Carla |e investigator |4 oth | |
| 700 | 1 | |a Chishti, Aftab |e investigator |4 oth | |
| 700 | 1 | |a Klein, Jon |e investigator |4 oth | |
| 700 | 1 | |a Katsoufis, Chryso |e investigator |4 oth | |
| 700 | 1 | |a Seeherunvong, Wacharee |e investigator |4 oth | |
| 700 | 1 | |a Rheault, Michelle |e investigator |4 oth | |
| 700 | 1 | |a Wong, Craig |e investigator |4 oth | |
| 700 | 1 | |a Mathews, Nisha |e investigator |4 oth | |
| 700 | 1 | |a Barcia, John |e investigator |4 oth | |
| 700 | 1 | |a Swiatecka-Urban, Agnes |e investigator |4 oth | |
| 700 | 1 | |a Bartosh, Sharon |e investigator |4 oth | |
| 700 | 1 | |a Hunley, Tracy |e investigator |4 oth | |
| 700 | 1 | |a Dharnidharka, Vikas |e investigator |4 oth | |
| 700 | 1 | |a Gaut, Joseph |e investigator |4 oth | |
| 700 | 1 | |a Laurin, Louis-Philippe |e investigator |4 oth | |
| 700 | 1 | |a Royal, Virginie |e investigator |4 oth | |
| 700 | 1 | |a Achanti, Anand |e investigator |4 oth | |
| 700 | 1 | |a Budisavljevic, Milos |e investigator |4 oth | |
| 700 | 1 | |a Self, Sally |e investigator |4 oth | |
| 700 | 1 | |a Ghossein, Cybele |e investigator |4 oth | |
| 700 | 1 | |a Wadhwani, Shikha |e investigator |4 oth | |
| 700 | 1 | |a Ayoub, Isabelle |e investigator |4 oth | |
| 700 | 1 | |a Nadasdy, Tibor |e investigator |4 oth | |
| 700 | 1 | |a Parikh, Samir |e investigator |4 oth | |
| 700 | 1 | |a Rovin, Brad |e investigator |4 oth | |
| 700 | 1 | |a Chang, Anthony |e investigator |4 oth | |
| 700 | 1 | |a Fatima, Huma |e investigator |4 oth | |
| 700 | 1 | |a Novak, Jan |e investigator |4 oth | |
| 700 | 1 | |a Renfrow, Matthew |e investigator |4 oth | |
| 700 | 1 | |a Rizk, Dana |e investigator |4 oth | |
| 773 | 0 | 8 | |i Enthalten in |t American journal of kidney diseases : the official journal of the National Kidney Foundation |d 1982 |g 81(2023), 3 vom: 01. März, Seite 318-328.e1 |w (DE-627)NLM012600814 |x 1523-6838 |7 nnns |
| 773 | 1 | 8 | |g volume:81 |g year:2023 |g number:3 |g day:01 |g month:03 |g pages:318-328.e1 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1053/j.ajkd.2022.08.010 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 81 |j 2023 |e 3 |b 01 |c 03 |h 318-328.e1 | ||