Hospitalizations for COVID-19 Among US People Experiencing Incarceration or Homelessness

People experiencing incarceration (PEI) and people experiencing homelessness (PEH) have an increased risk of COVID-19 exposure from congregate living, but data on their hospitalization course compared with that of the general population are limited. To compare COVID-19 hospitalizations for PEI and P...

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Veröffentlicht in:JAMA network open 2022-01, Vol.5 (1), p.e2143407-e2143407
Hauptverfasser: Montgomery, Martha P, Hong, Kai, Clarke, Kristie E N, Williams, Samantha, Fukunaga, Rena, Fields, Victoria L, Park, Joohyun, Schieber, Lyna Z, Kompaniyets, Lyudmyla, Ray, Colleen M, Lambert, Lauren A, D'Inverno, Ashley S, Ray, Tapas K, Jeffers, Alexiss, Mosites, Emily
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container_title JAMA network open
container_volume 5
creator Montgomery, Martha P
Hong, Kai
Clarke, Kristie E N
Williams, Samantha
Fukunaga, Rena
Fields, Victoria L
Park, Joohyun
Schieber, Lyna Z
Kompaniyets, Lyudmyla
Ray, Colleen M
Lambert, Lauren A
D'Inverno, Ashley S
Ray, Tapas K
Jeffers, Alexiss
Mosites, Emily
description People experiencing incarceration (PEI) and people experiencing homelessness (PEH) have an increased risk of COVID-19 exposure from congregate living, but data on their hospitalization course compared with that of the general population are limited. To compare COVID-19 hospitalizations for PEI and PEH with hospitalizations among the general population. This cross-sectional analysis used data from the Premier Healthcare Database on 3415 PEI and 9434 PEH who were evaluated in the emergency department or were hospitalized in more than 800 US hospitals for COVID-19 from April 1, 2020, to June 30, 2021. Incarceration or homelessness. Hospitalization proportions were calculated. and outcomes (intensive care unit admission, invasive mechanical ventilation [IMV], mortality, length of stay, and readmissions) among PEI and PEH were compared with outcomes for all patients with COVID-19 (not PEI or PEH). Multivariable regression was used to adjust for potential confounders. In total, 3415 PEI (2952 men [86.4%]; mean [SD] age, 50.8 [15.7] years) and 9434 PEH (6776 men [71.8%]; mean [SD] age, 50.1 [14.5] years) were evaluated in the emergency department for COVID-19 and were hospitalized more often (2170 of 3415 [63.5%] PEI; 6088 of 9434 [64.5%] PEH) than the general population (624 470 of 1 257 250 [49.7%]) (P 
doi_str_mv 10.1001/jamanetworkopen.2021.43407
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To compare COVID-19 hospitalizations for PEI and PEH with hospitalizations among the general population. This cross-sectional analysis used data from the Premier Healthcare Database on 3415 PEI and 9434 PEH who were evaluated in the emergency department or were hospitalized in more than 800 US hospitals for COVID-19 from April 1, 2020, to June 30, 2021. Incarceration or homelessness. Hospitalization proportions were calculated. and outcomes (intensive care unit admission, invasive mechanical ventilation [IMV], mortality, length of stay, and readmissions) among PEI and PEH were compared with outcomes for all patients with COVID-19 (not PEI or PEH). Multivariable regression was used to adjust for potential confounders. In total, 3415 PEI (2952 men [86.4%]; mean [SD] age, 50.8 [15.7] years) and 9434 PEH (6776 men [71.8%]; mean [SD] age, 50.1 [14.5] years) were evaluated in the emergency department for COVID-19 and were hospitalized more often (2170 of 3415 [63.5%] PEI; 6088 of 9434 [64.5%] PEH) than the general population (624 470 of 1 257 250 [49.7%]) (P &lt; .001). Both PEI and PEH hospitalized for COVID-19 were more likely to be younger, male, and non-Hispanic Black than the general population. Hospitalized PEI had a higher frequency of IMV (410 [18.9%]; adjusted risk ratio [aRR], 1.16; 95% CI, 1.04-1.30) and mortality (308 [14.2%]; aRR, 1.28; 95% CI, 1.11-1.47) than the general population (IMV, 88 897 [14.2%]; mortality, 84 725 [13.6%]). Hospitalized PEH had a lower frequency of IMV (606 [10.0%]; aRR, 0.64; 95% CI, 0.58-0.70) and mortality (330 [5.4%]; aRR, 0.53; 95% CI, 0.47-0.59) than the general population. Both PEI and PEH had longer mean (SD) lengths of stay (PEI, 9 [10] days; PEH, 11 [26] days) and a higher frequency of readmission (PEI, 128 [5.9%]; PEH, 519 [8.5%]) than the general population (mean [SD] length of stay, 8 [10] days; readmission, 28 493 [4.6%]). In this cross-sectional study, a higher frequency of COVID-19 hospitalizations for PEI and PEH underscored the importance of adhering to recommended prevention measures. Expanding medical respite may reduce hospitalizations in these disproportionately affected populations.</description><identifier>ISSN: 2574-3805</identifier><identifier>EISSN: 2574-3805</identifier><identifier>DOI: 10.1001/jamanetworkopen.2021.43407</identifier><identifier>PMID: 35024835</identifier><language>eng</language><publisher>United States: American Medical Association</publisher><subject>Adult ; Aged ; Coronaviruses ; COVID-19 ; COVID-19 - epidemiology ; Cross-Sectional Studies ; Databases, Factual ; Female ; Homeless people ; Homeless Persons - statistics &amp; numerical data ; Hospitalization ; Hospitalization - statistics &amp; numerical data ; Humans ; Imprisonment ; Infectious Diseases ; Length of stay ; Male ; Middle Aged ; Mortality ; Online Only ; Original Investigation ; Population ; Prisoners - statistics &amp; numerical data ; SARS-CoV-2 ; United States</subject><ispartof>JAMA network open, 2022-01, Vol.5 (1), p.e2143407-e2143407</ispartof><rights>2022. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright 2022 Montgomery MP et al. .</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a473t-85bc645f9ec02a1f99a625eb2c20abe774b69490f09a040112c4fefb1e8723a53</citedby><cites>FETCH-LOGICAL-a473t-85bc645f9ec02a1f99a625eb2c20abe774b69490f09a040112c4fefb1e8723a53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,860,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35024835$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Montgomery, Martha P</creatorcontrib><creatorcontrib>Hong, Kai</creatorcontrib><creatorcontrib>Clarke, Kristie E N</creatorcontrib><creatorcontrib>Williams, Samantha</creatorcontrib><creatorcontrib>Fukunaga, Rena</creatorcontrib><creatorcontrib>Fields, Victoria L</creatorcontrib><creatorcontrib>Park, Joohyun</creatorcontrib><creatorcontrib>Schieber, Lyna Z</creatorcontrib><creatorcontrib>Kompaniyets, Lyudmyla</creatorcontrib><creatorcontrib>Ray, Colleen M</creatorcontrib><creatorcontrib>Lambert, Lauren A</creatorcontrib><creatorcontrib>D'Inverno, Ashley S</creatorcontrib><creatorcontrib>Ray, Tapas K</creatorcontrib><creatorcontrib>Jeffers, Alexiss</creatorcontrib><creatorcontrib>Mosites, Emily</creatorcontrib><title>Hospitalizations for COVID-19 Among US People Experiencing Incarceration or Homelessness</title><title>JAMA network open</title><addtitle>JAMA Netw Open</addtitle><description>People experiencing incarceration (PEI) and people experiencing homelessness (PEH) have an increased risk of COVID-19 exposure from congregate living, but data on their hospitalization course compared with that of the general population are limited. To compare COVID-19 hospitalizations for PEI and PEH with hospitalizations among the general population. This cross-sectional analysis used data from the Premier Healthcare Database on 3415 PEI and 9434 PEH who were evaluated in the emergency department or were hospitalized in more than 800 US hospitals for COVID-19 from April 1, 2020, to June 30, 2021. Incarceration or homelessness. Hospitalization proportions were calculated. and outcomes (intensive care unit admission, invasive mechanical ventilation [IMV], mortality, length of stay, and readmissions) among PEI and PEH were compared with outcomes for all patients with COVID-19 (not PEI or PEH). Multivariable regression was used to adjust for potential confounders. In total, 3415 PEI (2952 men [86.4%]; mean [SD] age, 50.8 [15.7] years) and 9434 PEH (6776 men [71.8%]; mean [SD] age, 50.1 [14.5] years) were evaluated in the emergency department for COVID-19 and were hospitalized more often (2170 of 3415 [63.5%] PEI; 6088 of 9434 [64.5%] PEH) than the general population (624 470 of 1 257 250 [49.7%]) (P &lt; .001). Both PEI and PEH hospitalized for COVID-19 were more likely to be younger, male, and non-Hispanic Black than the general population. Hospitalized PEI had a higher frequency of IMV (410 [18.9%]; adjusted risk ratio [aRR], 1.16; 95% CI, 1.04-1.30) and mortality (308 [14.2%]; aRR, 1.28; 95% CI, 1.11-1.47) than the general population (IMV, 88 897 [14.2%]; mortality, 84 725 [13.6%]). Hospitalized PEH had a lower frequency of IMV (606 [10.0%]; aRR, 0.64; 95% CI, 0.58-0.70) and mortality (330 [5.4%]; aRR, 0.53; 95% CI, 0.47-0.59) than the general population. Both PEI and PEH had longer mean (SD) lengths of stay (PEI, 9 [10] days; PEH, 11 [26] days) and a higher frequency of readmission (PEI, 128 [5.9%]; PEH, 519 [8.5%]) than the general population (mean [SD] length of stay, 8 [10] days; readmission, 28 493 [4.6%]). In this cross-sectional study, a higher frequency of COVID-19 hospitalizations for PEI and PEH underscored the importance of adhering to recommended prevention measures. Expanding medical respite may reduce hospitalizations in these disproportionately affected populations.</description><subject>Adult</subject><subject>Aged</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - epidemiology</subject><subject>Cross-Sectional Studies</subject><subject>Databases, Factual</subject><subject>Female</subject><subject>Homeless people</subject><subject>Homeless Persons - statistics &amp; numerical data</subject><subject>Hospitalization</subject><subject>Hospitalization - statistics &amp; numerical data</subject><subject>Humans</subject><subject>Imprisonment</subject><subject>Infectious Diseases</subject><subject>Length of stay</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Online Only</subject><subject>Original Investigation</subject><subject>Population</subject><subject>Prisoners - statistics &amp; numerical data</subject><subject>SARS-CoV-2</subject><subject>United States</subject><issn>2574-3805</issn><issn>2574-3805</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkVtP3DAQha0KVBDlL1RR-8JLtuNbEvNQCW2BXQkJpJaqb5bjTqiXxE7tbAv8esxVwINla3zO0cx8hHyiMKMA9MvKDMbj9D_EyzCinzFgdCa4gPod2WayFiVvQG68eG-R3ZRWAMCAclXJ92SLS2Ci4XKb_FqENLrJ9O7GTC74VHQhFvPTn8tvJVXFwRD8RXH-vTjDMPZYHF6NGB1663J56a2JFuO9sci2RRiwx5R8Ph_IZmf6hLuP9w45Pzr8MV-UJ6fHy_nBSWlEzaeyka2thOwUWmCGdkqZiklsmWVgWqxr0VZKKOhAGRBAKbOiw66l2NSMG8l3yNeH3HHdDvjbop-i6fUY3WDitQ7G6dc_3v3RF-Gfbmqp8k5ywN5jQAx_15gmPbhkse_zmsM6aVZRJYUAwbP08xvpKqyjz-NlVZV75VKorNp_UNkYUorYPTdDQd8x1G8Y6juG-p5hNn98Oc6z9YkYvwWHjZ2O</recordid><startdate>20220104</startdate><enddate>20220104</enddate><creator>Montgomery, Martha P</creator><creator>Hong, Kai</creator><creator>Clarke, Kristie E N</creator><creator>Williams, Samantha</creator><creator>Fukunaga, Rena</creator><creator>Fields, Victoria L</creator><creator>Park, Joohyun</creator><creator>Schieber, Lyna Z</creator><creator>Kompaniyets, Lyudmyla</creator><creator>Ray, Colleen M</creator><creator>Lambert, Lauren A</creator><creator>D'Inverno, Ashley S</creator><creator>Ray, Tapas K</creator><creator>Jeffers, Alexiss</creator><creator>Mosites, Emily</creator><general>American Medical Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>COVID</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20220104</creationdate><title>Hospitalizations for COVID-19 Among US People Experiencing Incarceration or Homelessness</title><author>Montgomery, Martha P ; 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To compare COVID-19 hospitalizations for PEI and PEH with hospitalizations among the general population. This cross-sectional analysis used data from the Premier Healthcare Database on 3415 PEI and 9434 PEH who were evaluated in the emergency department or were hospitalized in more than 800 US hospitals for COVID-19 from April 1, 2020, to June 30, 2021. Incarceration or homelessness. Hospitalization proportions were calculated. and outcomes (intensive care unit admission, invasive mechanical ventilation [IMV], mortality, length of stay, and readmissions) among PEI and PEH were compared with outcomes for all patients with COVID-19 (not PEI or PEH). Multivariable regression was used to adjust for potential confounders. In total, 3415 PEI (2952 men [86.4%]; mean [SD] age, 50.8 [15.7] years) and 9434 PEH (6776 men [71.8%]; mean [SD] age, 50.1 [14.5] years) were evaluated in the emergency department for COVID-19 and were hospitalized more often (2170 of 3415 [63.5%] PEI; 6088 of 9434 [64.5%] PEH) than the general population (624 470 of 1 257 250 [49.7%]) (P &lt; .001). Both PEI and PEH hospitalized for COVID-19 were more likely to be younger, male, and non-Hispanic Black than the general population. Hospitalized PEI had a higher frequency of IMV (410 [18.9%]; adjusted risk ratio [aRR], 1.16; 95% CI, 1.04-1.30) and mortality (308 [14.2%]; aRR, 1.28; 95% CI, 1.11-1.47) than the general population (IMV, 88 897 [14.2%]; mortality, 84 725 [13.6%]). Hospitalized PEH had a lower frequency of IMV (606 [10.0%]; aRR, 0.64; 95% CI, 0.58-0.70) and mortality (330 [5.4%]; aRR, 0.53; 95% CI, 0.47-0.59) than the general population. Both PEI and PEH had longer mean (SD) lengths of stay (PEI, 9 [10] days; PEH, 11 [26] days) and a higher frequency of readmission (PEI, 128 [5.9%]; PEH, 519 [8.5%]) than the general population (mean [SD] length of stay, 8 [10] days; readmission, 28 493 [4.6%]). In this cross-sectional study, a higher frequency of COVID-19 hospitalizations for PEI and PEH underscored the importance of adhering to recommended prevention measures. Expanding medical respite may reduce hospitalizations in these disproportionately affected populations.</abstract><cop>United States</cop><pub>American Medical Association</pub><pmid>35024835</pmid><doi>10.1001/jamanetworkopen.2021.43407</doi><oa>free_for_read</oa></addata></record>
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subjects Adult
Aged
Coronaviruses
COVID-19
COVID-19 - epidemiology
Cross-Sectional Studies
Databases, Factual
Female
Homeless people
Homeless Persons - statistics & numerical data
Hospitalization
Hospitalization - statistics & numerical data
Humans
Imprisonment
Infectious Diseases
Length of stay
Male
Middle Aged
Mortality
Online Only
Original Investigation
Population
Prisoners - statistics & numerical data
SARS-CoV-2
United States
title Hospitalizations for COVID-19 Among US People Experiencing Incarceration or Homelessness
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