Disparities among patients with respiratory failure

Author:

Blank Jessica A.1,Armstrong-Hough Mari2,Valley Thomas S.345

Affiliation:

1. Department of Internal Medicine, University of Michigan

2. Department of Social & Behavioral Sciences, Department of Epidemiology, New York University School of Global Public Health

3. Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan

4. VA Center for Clinical Management Research

5. Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA

Abstract

Purpose of review Disparities are common within healthcare, and critical illness is no exception. This review summarizes recent literature on health disparities within respiratory failure, focusing on race, ethnicity, socioeconomic status, and sex. Recent findings Current evidence indicates that Black patients have higher incidence of respiratory failure, while the relationships among race, ethnicity, and mortality remains unclear. There has been renewed interest in medical device bias, specifically pulse oximetry, for which data demonstrate patients with darker skin tones may be at risk for undetected hypoxemia and worse outcomes. Lower socioeconomic status is associated with higher mortality, and respiratory failure can potentiate socioeconomic inequities via illness-related financial toxicity. Literature on sex-based disparities is limited; however, evidence suggests males receive more invasive care, including mechanical ventilation. Summary Most studies focused on disparities in incidence and mortality associated with respiratory failure, but few relied on granular clinical data of patients from diverse backgrounds. Future studies should evaluate processes of care for respiratory failure that may mechanistically contribute to disparities in order to develop interventions that improve outcomes.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Critical Care and Intensive Care Medicine

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