AHRQ Data Highlight Inequities Related to COVID-19 Hospitalizations and How Vaccination Prioritization May Effect Equity

In the first months of the pandemic, Black and Hispanic patients accounted for a larger share of COVID-19-related hospitalizations than White patients, according to a new data analysis from the Agency for Healthcare Research and Quality (AHRQ). A second data analysis demonstrates how different vaccine distribution prioritization plans may lead to different levels of equity across income and race/ethnicity.

“AHRQ analysts continue to produce important insights into the pandemic and help healthcare policymakers make informed decisions,” said AHRQ Acting Director David Meyers, M.D. “AHRQ uses data to identify disparities and to discover options for promoting equity.”   

In April, May and June 2020, 48.6 percent of COVID-19 hospitalizations were for Black and Hispanic patients, while 38.8 percent of these hospitalizations were for White patients, according to new data from AHRQ’s Healthcare Cost and Utilization Project (HCUP). In the aggregate across nine states, the average in-hospital death rate related to COVID-19 in April 2020 was 17.5 percent and declined to 10.7 percent in June 2020.  The average in-hospital death rate varied by the patient’s race/ethnicity and by the state in which the hospital was located, according to the HCUP statistical brief COVID-19-Related Hospitalizations in Nine States, by Race/Ethnicity, 2020 (PDF, 550 KB). All data information contained in the brief can be found in the HCUP Summary Trend Tables, which provide state-specific monthly trends in hospital utilization. The nine states—Arizona, Georgia, Iowa, Maryland, Michigan, Minnesota, New Jersey, Ohio, and Wisconsin—are ones for which data were available for April, May and June for both 2019 and 2020.

In the second analysis, COVID-19 Vaccination Prioritization Scenarios and Their Effects on Eligibility by Poverty Level, Race, and Ethnicity, AHRQ researchers used data from its Medical Expenditure Panel Survey (MEPS) to examine how three hypothetical prioritizations would affect the vaccine eligibility of population groups defined by age, health status, employment characteristics, poverty level, and race/ethnicity.

The researchers found that distributing the vaccine by age would simplify eligibility, but it also would slow vaccine eligibility for adults in some minority racial and ethnic groups and for adults with family incomes below the federal poverty level. In another hypothetical scenario, granting high priority to most essential workers and adults age 65 and older would result in greater vaccine eligibility among adults in higher-income families and White adults than among adults living in poverty or racial and ethnic minorities, respectively. And according to the third vaccine distribution scenario studied, prioritizing adults at increased risk of severe COVID-19 ahead of non-healthcare high-priority occupation groups would increase access to the vaccine among Black adults and other adults living in poverty. However, this would delay eligibility for some workers who have increased risk of exposure and increased risk of transmission to others, the AHRQ researchers found. 

The researchers stress that this report may help policymakers understand how alternative prioritization strategies can affect the timing with which key population subgroups gain vaccine eligibility.

About HCUP

The Healthcare Cost and Utilization Project (HCUP) is a family of healthcare databases and the nation’s most comprehensive source of hospital care data, including information on in-patient stays, ambulatory surgery and visits to the emergency department. HCUP enables researchers, insurers, policymakers and others to study healthcare delivery and patient outcomes over time, and at the national, regional, state, and community levels. More information about HCUP can be found at https://www.ahrq.gov/data/hcup/index.html. 

About MEPS

The Medical Expenditure Panel Survey (MEPS) is the only nationally representative data source measuring how Americans use and pay for medical care, health insurance coverage, and out-of-pocket spending, and their satisfaction with their care. More information about MEPS can be found at https://www.ahrq.gov/data/meps.html.

About AHRQ

AHRQ’s mission is to produce evidence to make healthcare safer, higher quality, more accessible, equitable, and affordable, and to work within HHS and with other partners to make sure that the evidence is understood and used.

Contact: 

AHRQ Office of Communications
karen.carp@ahrq.hhs.gov
301-427-1858