Racial Disparities in Stroke Care before and during COVID-19 in a Universal Health System: A Multiple-Group...

Area of Science:

• Health Services Research
• Health Equity
• Epidemiology

Background:

• The COVID-19 pandemic strained healthcare systems globally, potentially worsening existing health disparities.
• Black populations often face barriers to timely, quality healthcare, leading to poorer health outcomes.
• This study investigated the impact of the pandemic on stroke care within Colombia's universal healthcare system, focusing on racial disparities.

Purpose of the Study:

• To evaluate how Colombia's universal healthcare system responded to the COVID-19 pandemic.
• To determine if the pandemic exacerbated or mitigated racial disparities in stroke care.
• To analyze differences in healthcare access, treatment duration, and mortality between Black and White populations.

Main Methods:

• Utilized a multiple-group interrupted time-series analysis.
• Analyzed panel data from Colombia spanning 2016 to 2021.
• Assessed the pandemic's impact on stroke care metrics stratified by race (Black and White populations).

Main Results:

• The universal healthcare system offered a protective effect for White individuals during the pandemic.
• While healthcare access declined for both groups, Black patients saw an initial increase in hospital stay duration followed by a decline, whereas White patients' durations increased.
• Discharge mortality rates, already higher for Black individuals pre-pandemic, increased by 3% during the pandemic, while decreasing for White individuals.

Conclusions:

• Universal health coverage alone is insufficient to eliminate racial disparities during health crises.
• Policy interventions must focus on enhancing healthcare infrastructure in underserved regions.
• Addressing implicit biases within healthcare delivery is crucial for ensuring equitable care during public health emergencies.