--- title: "Disparities in COVID-19 outcomes in large healthcare system. | Sutter Health" description: "Our study provides real-world evidence that there are racial and ethnic disparities in the presentation of COVID-19." url: "https://www.sutterhealth.org/research/publications/disparities-in-covid-19-outcomes-in-large-healthcare-system-1055312778" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Disparities in COVID-19 outcomes in large healthcare system. # Disparities In outcomes among COVID-19 patients In a large health care system In California. Azar KMJ, Shen Z, Romanelli RJ, Lockhart SH, Smits K, Robinson S, Brown S, & Pressman AR. _Health Aff (Millwood). 101377hlthaff202000598. doi: 10.1377/hlthaff.2020.00598. \[Epub ahead of print\]_ 2020-05-21 ## Abstract As the coronavirus disease (COVID-19) pandemic spreads throughout the United States, evidence is mounting that racial and ethnic minorities and socioeconomically disadvantaged groups are bearing a disproportionate burden of illness and death. We conducted a retrospective cohort analysis of COVID-19 patients at Sutter Health, a large integrated health care system in northern California, to measure potential disparities. We used Sutter's integrated electronic health record to identify adults with suspected and confirmed COVID-19, and used multivariable logistic regression to assess risk of hospitalization, adjusting for known risk factors, such as race/ethnicity, sex, age, health, and socioeconomic variables. We analyzed 1,052 confirmed cases of COVID-19 from January 1-April 8, 2020. Among our findings, we observed that, compared with non-Hispanic white patients, African Americans had 2.7 times the odds of hospitalization, after adjusting for age, sex, comorbidities, and income. We explore possible explanations for this, including societal factors that either result in barriers to timely access to care or create circumstances in which patients view delaying care as the most sensible option. Our study provides real-world evidence that there are racial and ethnic disparities in the presentation of COVID-19. [PubMed abstract](https://pubmed.ncbi.nlm.nih.gov/32437224/) ![Kristen M J Azar, RN, MSN, MPH](https://dyn.mktgcdn.com/p/rFmyR1kiX8JzE5-XNwup0gVC1GRaVTlH7oSDlG0Tr5A/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Kristen M J Azar, RN, MSN, MPH Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/kristen-m-j-azar-rn-msn-mph-1049680985) ## Research topics - [COVID-19](https://www.sutterhealth.org/research-search-results?query=%22%5C%22COVID-19%5C%22%22) - [Health Disparities](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Disparities%5C%22%22) - [Health Policy](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Policy%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Racial disparities in service use among Medicaid beneficiaries after mandatory enrollment in managed care: a difference-in-differences approach.](https://www.sutterhealth.org/research/publications/race-disparities-medicaid-managed-care-1055312565) Tai-Seale M, Freund D, LoSasso A. Inquiry. 38(1):49-59. 2001 Apr 01 - Publication ### [Women’s out-of-pocket expenditures and dispensing patterns for oral contraceptive pills between 1996 and 2006.](https://www.sutterhealth.org/research/publications/oop-costs-dispensing-for-oral-contraceptives-1055312599) Liang SY, Grossman D, Phillips KA. Contraception. 83(6):528-36. doi: 10.1016/j.contraception.2010.09.013 2011 Jun 01 - Publication ### [Voting with their feet: patient exit and intergroup differences in propensity for switching usual source of care.](https://www.sutterhealth.org/research/publications/pt-exit-intergrp-diffs-switch-care-source-1055312541) Tai-Seale M. J Health Polit Policy Law. 29(3):491-514. 2004 Jun 01 - Publication ### [The long-term effects of Medicaid managed care on obstetrics care in three California counties.](https://www.sutterhealth.org/research/publications/medicaid-managed-care-obstetrics-ca-counties-1055312574) Tai-Seale M, LoSasso AT, Freund DA, Gerber SE. Health Serv Res. 36(4):751-71. 2001 Aug 01 - Publication ### [Association of mandated language access programming and quality of care provided by mental health agencies.](https://www.sutterhealth.org/research/publications/lang-access-care-quality-mental-health-agencies-1055312895) McClellan SR, Snowden L. Psychiatr Serv. 2014 Sep 15. doi: 10.1176/appi.ps.201300522. \[Epub ahead of print\] 2014 Sep 15 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/disparities-in-covid-19-outcomes-in-large-healthcare-system-1055312778#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Disparities in COVID-19 outcomes in large healthcare system."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/disparities-in-covid-19-outcomes-in-large-healthcare-system-1055312778#medicalscholarlyarticle","name":"Disparities In outcomes among COVID-19 patients In a large health care system In California.","headline":"Disparities in COVID-19 outcomes in large healthcare system.","abstract":"As the coronavirus disease (COVID-19) pandemic spreads throughout the United States, evidence is mounting that racial and ethnic minorities and socioeconomically disadvantaged groups are bearing a disproportionate burden of illness and death. We conducted a retrospective cohort analysis of COVID-19 patients at Sutter Health, a large integrated health care system in northern California, to measure potential disparities. We used Sutter's integrated electronic health record to identify adults with suspected and confirmed COVID-19, and used multivariable logistic regression to assess risk of hospitalization, adjusting for known risk factors, such as race/ethnicity, sex, age, health, and socioeconomic variables. We analyzed 1,052 confirmed cases of COVID-19 from January 1-April 8, 2020. Among our findings, we observed that, compared with non-Hispanic white patients, African Americans had 2.7 times the odds of hospitalization, after adjusting for age, sex, comorbidities, and income. We explore possible explanations for this, including societal factors that either result in barriers to timely access to care or create circumstances in which patients view delaying care as the most sensible option. Our study provides real-world evidence that there are racial and ethnic disparities in the presentation of COVID-19.","description":"Our study provides real-world evidence that there are racial and ethnic disparities in the presentation of COVID-19.","keywords":["COVID-19","Health Disparities","Health Policy"],"datePublished":"2020-05-21","url":"https://www.sutterhealth.org/research/publications/disparities-in-covid-19-outcomes-in-large-healthcare-system-1055312778","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"PMID","value":"32437224"},{"@type":"PropertyValue","propertyID":"DOI","value":"10.1377/hlthaff.2020.00598"}],"sameAs":["https://pubmed.ncbi.nlm.nih.gov/32437224/","https://doi.org/10.1377/hlthaff.2020.00598"],"isPartOf":{"@type":"Periodical","name":"Health Aff (Millwood)"},"author":[{"@type":"Person","@id":"https://www.sutterhealth.org/research/investigators/kristen-m-j-azar-rn-msn-mph-1049680985","name":"Azar KMJ","url":"https://www.sutterhealth.org/research/investigators/kristen-m-j-azar-rn-msn-mph-1049680985"},{"@type":"Person","name":"Shen Z"},{"@type":"Person","name":"Romanelli RJ"},{"@type":"Person","name":"Lockhart SH"},{"@type":"Person","name":"Smits K"},{"@type":"Person","name":"Robinson S"},{"@type":"Person","name":"Brown S"},{"@type":"Person","name":"Pressman AR"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"COVID-19","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22COVID-19%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Health Disparities","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Disparities%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Health Policy","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Policy%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/disparities-in-covid-19-outcomes-in-large-healthcare-system-1055312778","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/disparities-in-covid-19-outcomes-in-large-healthcare-system-1055312778#breadcrumblist"}}} ```