Evaluating Approaches to Improve Equity in Critical Care Resource Allocation in the COVID-19 Pandemic

• Type of Material: Article
• Authors: Katherine Ross-Driscoll, Emory University; Gregory Esper, Emory University; Kathleen Kinlaw, Emory University; Yi-Ting Hana Lee, Emory University; Alanna Morris, Emory University; David Murphy, Emory University; Rebecca Pentz, Emory University; Chad Robichaux, Emory University; Gerard Vong, Emory University; Kevin Wack, Emory Healthcare; Neal Dickert, Emory University
• Language: English
• Date: 2021-12-15
• Publisher: AMER THORACIC SOC
• Publication Version: Final Published Version
• Copyright Statement: © 2021 by the American Thoracic Society
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1164/rccm.202106-1462LE
• Title of Journal or Parent Work: AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
• Volume: 204
• Issue: 12
• Start Page: 1481
• End Page: 1484
• Keywords: Life Sciences & Biomedicine; Critical Care Medicine; Respiratory System; Science & Technology; General & Internal Medicine
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

The coronavirus disease (COVID-19) pandemic has forced healthcare systems to develop strategies to allocate critical care resources when demand outstrips supply (1). The pandemic has also disproportionately impacted Black patients (2, 3), for whom baseline health disparities are well documented and largely driven by inequity in social determinants of health. Concerns about the potential for inequity in resource allocation were raised early in the pandemic, especially if morbidity limiting near-term survival was factored into allocation decisions. Two mitigation strategies to avoid inequity in allocation have been proposed: eliminating consideration of expected survival beyond 1 year and incorporating measures of social disadvantage such as the Area Deprivation Index (ADI) (2, 4, 5).