Skip Navigation
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

National Institute of Environmental Health Sciences

Use this QR code to view the newest version of this document
Use this QR code to view the newest version of this document

Your Environment. Your Health.

Publication Detail

Title: Differences in COVID-19-Related Testing and Healthcare Utilization by Race and Ethnicity in the Veterans Health Administration.

Authors: Razjouyan, Javad; Helmer, Drew A; Li, Ang; Naik, Aanand D; Amos, Christopher I; Bandi, Venkata; Sharafkhaneh, Amir

Published In J Racial Ethn Health Disparities, (2022 Apr)

Abstract: IMPORTANCE: Recent reports indicate differences in COVID-19-related care and outcomes between Black and White Americans. OBJECTIVE: We examine the COVID-19-related healthcare utilization and mortality by race and ethnicity of patients tested for SARS-CoV-2 in the Veterans Health Administration (VHA). DESIGN: A retrospective cohort study. SETTING: We used the VHA COVID-19 shared data resources between February 1 and June 30, 2020. PARTICIPANTS: Veterans tested for SARS-CoV-2 virus by VHA. EXPOSURE(S): Three racial-ethnicity groups of Black, Hispanic, and White (as reference) veterans. MAIN OUTCOME(S) AND MEASURE(S): Main outcomes are testing rate, positivity rate, hospitalization rate, ICU admission rate, and in-hospital mortality. Controlling for sex, age, and Elixhauser comorbidity index, we report adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) from logistic regression models. RESULTS: Of the 8,667,996 active veteran enrollees, 252,702 were tested by VHA from February to June, 2020, with 20,500 positive results and 4,790 hospitalizations. The testing rate was 4.4% among Black and 4.7% among Hispanic veterans compared to White veterans, 2.8%. The testing positivity rate was similarly elevated among Black (12.2%) and Hispanic (11.6%) veterans compared to White veterans (6.0%). The aORs of hospitalization in Black veterans (1.88; 95% CI 1.74, 2.03) and Hispanic veterans (1.41; 95% CI 1.25, 1.60) were higher compared to White veterans. No significant differences by race and ethnicity were observed in OR or aOR of ICU admission and in-hospital death among hospitalized patients. CONCLUSIONS AND RELEVANCE: On a national level, the VHA was more likely to test and hospitalize Black and Hispanic veterans compared to White veterans, but there were no significant differences in ICU admission or in-hospital mortality among those hospitalized. This pattern of differences may relate to social determinants of health, factors affecting access to non-VHA care, or preferences for VHA care affecting initial care seeking, but not in-hospital outcomes.

PubMed ID: 33694124 Exiting the NIEHS site

MeSH Terms: COVID-19*/therapy; Ethnicity; Hospital Mortality; Humans; Patient Acceptance of Health Care; Retrospective Studies; SARS-CoV-2; United States/epidemiology; Veterans Health; Veterans*

Back
to Top