Date of Award
2028
Degree Type
Restricted to Claremont Colleges Dissertation
Degree Name
Health Promotion Sciences, PhD
Program
School of Community and Global Health
Advisor/Supervisor/Committee Chair
Deborah A. Freund
Dissertation or Thesis Committee Member
Bin Xie
Dissertation or Thesis Committee Member
Frederick Lynch
Dissertation or Thesis Committee Member
Daniel Gluckstein
Terms of Use & License Information
Rights Information
© 2025 Pamela C Ogata
Keywords
Community hospital, COVID-19, Health insurance, Length of stay, Mortality
Subject Categories
Epidemiology
Abstract
The COVID-19 pandemic left an indelible mark on the well-being of individuals and communities worldwide. More than 6.7 million people lost their lives to COVID-19 within the first three years, and countless others have died because of COVID-19 related matters. As the scientific community continues to grapple with the multifaceted repercussions of the virus, gaining a full understanding of predictors for poor COVID-19 health outcomes is critical. The purpose of these single-center retrospective cohort studies is to explore the association between health insurance type, community economic wellness, and two health outcomes (length of stay and mortality). Data from adult patients who were hospitalized with COVID-19 at a community hospital in eastern Los Angeles County and western San Bernardino County, California between March 9, 2020, and April 30, 2021, were used in the logistic and zero truncated negative binominal regression analyses. The results from the trilogy of studies showed that insurance type was not an independent predictive measure in inpatient mortality. Medicaid patients with COVID-19 did not have higher odds of mortality compared to patients covered by private insurance policies or Medicare. There was also no significant difference in odds of death between inpatients with managed care coverage compared to those with traditional fee-for-service insurance plans. Although there were some statistically significant differences in average length of stay between insurance types, the difference in length of stay between each insurance type was minimal. Overall, insurance type was not associated with length of stay after adjusting for covariates among inpatients discharged alive. Community deprivation was significantly associated with increased odds of COVID-19 inpatient mortality in the univariate analysis. However, after adjusting for individua-level covariates, community deprivation was no longer an independent predictor. The lack of meaningful association between insurance type and COVID-19 inpatient outcomes carry important political and policy implications for future research and discussion on health system reform.
ISBN
9798273332706
Recommended Citation
Ogata, Pamela. (2028). Health and Wealth: Relationship Between Unexplored Economic Factors and COVID-19 Inpatient Health Outcomes. CGU Theses & Dissertations, 1061. https://scholarship.claremont.edu/cgu_etd/1061.
