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Intersection of Race and Rurality With Health Care-Associated Infections and Subsequent Outcomes.

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Summary
This summary is machine-generated.

Structural disadvantages like race and rurality are linked to health care-associated infections (HAIs) and worse outcomes. Addressing these inequities is crucial for patient health.

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Area of Science:

  • Health Services Research
  • Epidemiology
  • Health Equity

Background:

  • Health care-associated infections (HAIs) represent a significant burden on patient morbidity and mortality.
  • Limited understanding exists regarding the influence of structural factors, specifically race and rurality, on HAI development and patient outcomes.

Purpose of the Study:

  • To investigate the association between patient race and rurality, serving as proxies for structural disadvantage, and the incidence of HAIs.
  • To evaluate the subsequent outcomes for patients experiencing HAIs, considering their race and rurality.

Main Methods:

  • A cohort study was conducted involving adult patients admitted to 3 US urban and suburban hospitals.
  • Data included patient race (Black or White) and residence (urban or rural), with HAIs defined by positive cultures obtained 48 hours post-admission.
  • Multivariable generalized estimating equations were employed to analyze the association of race and rurality with HAIs and post-HAI outcomes (ICU admission, in-hospital death).

Main Results:

  • Among 214,955 patients, 3.1% developed HAIs.
  • Black urban patients showed a decreased risk of HAI compared to White urban patients (aRR, 0.81).
  • White rural patients had an increased HAI risk (aRR, 1.12), while Black rural patients had a similar risk (aRR, 1.08).
  • Black rural patients with HAIs faced higher risks of ICU admission (aRR, 1.92) and in-hospital death (aRR, 1.78).

Conclusions:

  • This study highlights racial and rural disparities in HAI incidence and adverse outcomes.
  • Findings suggest that structural racism and rural disinvestment may contribute to these health inequities.
  • Addressing structural factors through policy and process changes is essential to mitigate disparities in HAI risk and outcomes.