Charity coverage and decreased COVID-19 mortality among uninsured patients in Texas: A retrospective cohort study

Anisha P Ganguly, John T Battaile, Michael Harms, Shannon Murray, Tami Gurley, Robert W Haley, Mamta K Jain and Kavita P Bhavan

PLOS ONE, 2025, vol. 20, issue 9, 1-12

Abstract: Purpose: Decreased access to care and social drivers of health have been implicated in COVID-19 disparities. The objective of this study was to test the association between county-funded charity coverage (CFCC) and mortality among uninsured patients hospitalized with COVID-19 in a highly uninsured county. Methods: This retrospective cohort study compared electronic health record (EHR) data among uninsured patients hospitalized with COVID-19 in a high-volume safety-net health system in Dallas County, Texas between June 2020 and December 2021. Uninsured patients included CFCC recipients and self-pay patients. We compared mortality over 180 days of follow-up using Cox proportional hazards models, adjusting for gender, age, race/ethnicity, and co-morbidities. Additional outcomes included 90-day mortality, need for mechanical ventilation, and intubation within 24 hours of presentation. Results: Among 2,047 patients, 47.0% received CFCC and 53.0% were self-pay. Overall, CFCC patients were older, more likely Hispanic, and had more diagnosed co-morbidities. CFCC patients had decreased adjusted mortality compared to self-pay (aHR 0.61, 95% CI [0.45 to 0.82], p

Date: 2025
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0330533

DOI: 10.1371/journal.pone.0330533

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