09 Aug Disparities in Access to ICU Beds During COVID-19 Pandemic

MedicalResearch.com Interview with:

Dr. Kanter

Genevieve Kanter, PhD
Leonard Davis Institute of Health Economic
Research Assistant Professor, General Internal Medicine,
Assistant Professor, Medical Ethics and Health Policy
Perelman School of Medicine

MedicalResearch.com: What is the background for this study?

Response: With the resurgence of COVID-19 and the likely seasonal resurgences, we were interested in whether those in low-income areas would be able to get access to the hospital care they might need. So we examined the distribution of ICU beds across the country and also looked at differences in the availability of ICU beds by household income in the community. 

MedicalResearch.com: What are the main findings?

Response: We had 3 main findings:

The first was that there was a huge amount of variation in the availability of ICU beds across the country. About 37% of communities had zero ICU beds. When we looked to see where these communities were, we saw that there was a huge correlation between household income and availability of ICU beds.

We found that about a half of the lowest-income communities (less than $35,000 in household income) had zero ICU beds, while only 3% of the highest-income communities ($90,000 or more). That’s our second finding.

Our third finding was that the greatest disparity was in rural areas, which is where COVID-19 is rolling through right now. 

MedicalResearch.com: What should readers take away from your report?

Response: Since better-resourced with ICU bed availability are not exactly lining up to take on expensive COVID-19 patients who might be uninsured or underinsured (since these hospitals are experiencing their own financial losses during the pandemic), we recommend that policymakers ensure that there is a plan and clear criteria for transfer of patients between hospitals to ensure that hospitals are sharing the patient load. We also included, in our Appendix, a list of communities most at risk so that policymakers can direct their attention and resources to areas that might be in need in the future.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Some important areas of research will be to investigate why there is such variation in the availability of ICU beds in general – not just related to income, and what can be done to temporarily expand ICU bed capacity and streamline hospital transfers in the face of COVID-19.

I have no financial interests to disclose.

Thank you for your interest in this paper and the topic!

Citation: 

Income Disparities In Access To Critical Care Services
Genevieve P. Kanter, Andrea G. Segal, and Peter W. Groeneveld
Health Affairs 2020 39:8, 1362-1367
https://www.healthaffairs.org/doi/10.1377/hlthaff.2020.00581

Last Modified: [last-modified] 

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Last Updated on August 10, 2020 by Marie Benz MD FAAD