Racial differences in length of stay and readmission for asthma in the all of us research program

• Published in: Journal of translational medicine 2024-01, Vol.22 (1), p.22-10, Article 22
• Main Authors: Correa-Agudelo, Esteban, Gautam, Yadu, Mendy, Angelico, Mersha, Tesfaye B
• Format: Article
• Language: English
• Subjects: Admission and discharge; Allergic rhinitis; Asthma; Asthma - therapy; Bayes Theorem; Bayesian analysis; Bayesian mixed-effects; Cardiovascular disease; Causal inference; Chronic illnesses; Chronic obstructive pulmonary disease; Clinical medicine; Codes; Comorbidities; Comorbidity; Demographic aspects; Dermatitis; Diagnosis; Electronic health records; Emergency medical care; Esophagus; Ethnicity; Evaluation; Food allergies; Hay fever; Hospitals; Humans; Length of Stay; Mathematical models; Outdoor air quality; Patient admissions; Patient care planning; Patient Readmission; Patients; Pediatrics; Population Health; Public health administration; Questionnaires; Race; Race Factors; Racial differences; Readmission; Retrospective Studies; Rhinitis; Risk factors; Socioeconomic factors; United States - epidemiology; Variables
• ISSN: 1479-5876; 1479-5876
• DOI: 10.1186/s12967-023-04826-9

This study addresses the limited research on racial disparities in asthma hospitalization outcomes, specifically length of stay (LOS) and readmission, across the U.S. We analyzed in-patient and emergency department visits from the All of Us Research Program, identifying various risk factors (demographic, comorbid, temporal, and place-based) associated with asthma LOS and 30-day readmission using Bayesian mixed-effects models. Of 17,233 patients (48.0% White, 30.7% Black, 19.7% Hispanic/Latino, 1.3% Asian, and 0.3% Middle Eastern and North African) with 82,188 asthma visits, Black participants had 20% shorter LOS and 12% higher odds of readmission, compared to White participants in multivariate analyses. Public-insured patients had 14% longer LOS and 39% higher readmission odds than commercially insured patients. Weekend admissions resulted in a 12% shorter LOS but 10% higher readmission odds. Asthmatics with chronic diseases had a longer LOS (range: 6-39%) and higher readmission odds (range: 9-32%) except for those with allergic rhinitis, who had a 23% shorter LOS. A comprehensive understanding of the factors influencing asthma hospitalization, in conjunction with diverse datasets and clinical-community partnerships, can help physicians and policymakers to systematically address racial disparities, healthcare utilization and equitable outcomes in asthma care.