Risk Factors for Severe Outcomes in COVID-19 Confirmed or Suspected Beneficiaries Enrolled in Mississippi Medicaid
Author(s)
Rong Y1, Ramachandran S2, Pittman E3, Bhattacharya K4, Bentley JP2, Banahan III B5, Kirby T6, Drone S7
1University of Mississippi, Amherst, MA, USA, 2University of Mississippi, Oxford, MS, USA, 3University of Mississippi, University, MS, USA, 4Department of Pharmacy Administration, University of Mississippi School of Pharmacy, University, MS, USA, 5Center for Pharmaceutical Marketing and Management, University of Mississippi, University, MS, USA, 6Office of the Governor, Mississippi Division of Medicaid, Jackson, MS, USA, 7Office of Information Technology Management (iTECH), Mississippi Division of Medicaid, Jackson, MS, USA
OBJECTIVES Previous research identifying risk factors for severe outcomes among COVID patients has not specifically focused on a low-income Medicaid population. This study identified the risk factors predicting COVID-related hospitalization and all-cause death in Medicaid-enrolled patients confirmed or suspected to be infected with the novel SARS-CoV-2 virus. METHODS A retrospective cohort study was conducted using Mississippi Medicaid claims data from March 2019 to November 2020. Inclusion criteria were a medical claim with diagnosis of confirmed or suspected COVID-19 and ages 18-64 years. Continuous eligibility for 12 months pre-index through 6 months post-index period was required. Suspected or confirmed COVID-19 was identified using diagnosis codes in the claim records between March and May 2020. Multivariable logistic regression was used to estimate the relationships between COVID-related hospitalization/death and demographics, comorbidities and residency in long-term care facilities. RESULTS A total of 3,850 beneficiaries met the inclusion criteria. Among these, 560 (14.5%) were confirmed to have COVID-19 infection. The rates of COVID-related hospitalization and all-cause death in the study population were 3.95% and 4.68%, respectively. Multivariable logistic regression showed that the odds of hospitalization were greater for patients aged 45 and older (OR:3.26, 95%CI:2.03-5.25), with Black race (OR:1.87, 95%CI:1.16-3.00), diabetes (OR:1.92, 95%CI:1.32-2.78), hypertension (OR:2.62, 95%CI:1.52-4.54), heart failure (OR:1.96, 95%CI:1.25-3.05), living in long-term care facilities (OR:4.24, 95%CI:2.69-6.69) and no-smoking status (OR:3.84, 95%CI:2.13-6.90). Odds of death were higher for patients aged 45 and older (OR:3.52, 95%CI:2.23-5.55), with diabetes (OR:1.81, 95%CI:1.28-2.55), heart failure (OR:2.11, 95%CI:1.41-3.15), COPD (OR:1.64, 95%CI:1.12-2.39), living in long-term care facilities (OR:1.77, 95%CI:1.09-2.87) and male sex (OR:2.19, 95%CI:1.56-3.08). Subgroup analysis on confirmed patients showed similar findings. CONCLUSIONS Results found that COVID-suspected or confirmed beneficiaries with older age, male sex, Black race, a history of chronic diseases, and those living in long-term care facilities might have higher odds of severe outcomes.
Conference/Value in Health Info
2021-05, ISPOR 2021, Montreal, Canada
Value in Health, Volume 24, Issue 5, S1 (May 2021)
Code
PIN40
Topic
Clinical Outcomes, Epidemiology & Public Health
Topic Subcategory
Clinical Outcomes Assessment, Public Health
Disease
Infectious Disease (non-vaccine)
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