title: Burden of present-on-admission infections and health care-associated infections, by race and ethnicity.
abstract: BACKGROUND
  In the United States incidence of sepsis and pneumonia differ by race, but it is unclear whether this is due to intrinsic factors or health care factors.
  
  
  METHODS
  We conducted a study of 52,006 patients hospitalized during 2006-2008 at a referral hospital in upper Manhattan. We examined how the prevalence of present-on-admission and health care-associated infection compared between non-Hispanic blacks, Hispanics, and non-Hispanic whites adjusting for sociodemographic factors, admission through the emergency department, and comorbid conditions.
  
  
  RESULTS
  Non-Hispanic blacks had 1.59-fold (95% confidence interval [CI], 1.29-1.96) and 1.55-fold (95% CI, 1.35-1.77) risk of community-acquired bloodstream infection and urinary tract infection compared with non-Hispanic whites. Hispanic patients had 1.31-fold (95% CI, 1.15-1.49) risk of presenting with community-acquired urinary tract infection compared with non-Hispanic whites. Controlling for admission through the emergency department, comorbidity, and neighborhood income attenuated the differences in prevalence of infections.
  
  
  CONCLUSIONS
  We found that health disparities in present-on-admission infections might be largely explained by potential lack of ambulatory care, socioeconomic factors, and comorbidity.
authors.affiliation: Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA. Electronic address: christie.jeon@cshs.org.
authors.forename: Christie Y
authors.initials: CY
authors.lastname: Jeon
authors.affiliation: Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY.
authors.forename: Peter
authors.initials: P
authors.lastname: Muennig
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Columbia University, New York, NY.
authors.forename: E Yoko
authors.initials: EY
authors.lastname: Furuya
authors.affiliation: School of Nursing, City University of New York School of Public Health, Hunter College Campus, New York, NY.
authors.forename: Bevin
authors.initials: B
authors.lastname: Cohen
authors.affiliation: CUNY School of Public Health at Hunter College, Hunter College Campus, New York, NY.
authors.forename: Denis
authors.initials: D
authors.lastname: Nash
authors.affiliation: School of Nursing, City University of New York School of Public Health, Hunter College Campus, New York, NY.
authors.forename: Elaine L
authors.initials: EL
authors.lastname: Larson
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data; D044383:Black People / Q000706:statistics & numerical data; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000208:ethnology*; D003428:Cross Infection / Q000453:epidemiology / Q000208:ethnology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data; D011014:Pneumonia / Q000453:epidemiology / Q000208:ethnology*; D015995:Prevalence; D012189:Retrospective Studies; D018805:Sepsis / Q000453:epidemiology / Q000208:ethnology*; D012959:Socioeconomic Factors; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000208:ethnology*; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American
keywords: Ambulatory care; Community-acquired infections; Health inequality