Access & Equity

How health care resources are distributed across the population and how access and health outcomes vary across different groups. LDI Senior Fellows focus on how to achieve greater access for vulnerable populations and how to reduce disparities in health outcomes.

Racial Bias in Mortality Prediction Scores

Mar. 31, 2021

The COVID-19 pandemic has forced us to face many uncomfortable realities. As critical care physicians, my colleagues and I work in intensive care units (ICUs) that have grown to accommodate the large numbers of patients who have become seriously ill from COVID-19 during the past year. However, the specter of scarcity has been looming. We know that a day may come when there are not enough ICU beds or ventilators for all the patients who need them.

The Relationship Between Surgeon Gender and Stress During the COVID-19 Pandemic

Jan. 22, 2021

Catherine L. Mavroudis, Sarah Landau, Ezra Brooks, Regan Bergmark, Nicholas L. Berlin, Blanche Blumenthal, Zara Cooper, Eun Kyeong Hwang, Elizabeth Lancaster, Jennifer Waljee, Elizabeth Wick, Heather Yeo, Christopher Wirtalla, Rachel R. Kelz

Abstract [from journal]

Objective: To investigate the relationship between surgeon gender and stress during the Covid-19 pandemic.

Background: While female surgeons face difficulties integrating work and home in the best of times, the Coronavirus Disease 2019 (Covid-19) pandemic has presented new challenges. The implications for the female surgical workforce are unknown.

Methods: This cross-sectional, multi-center telephone survey study of surgeons was conducted across five


Delayed Emergencies: The Composition and Magnitude of Non-Respiratory Emergency Department Visits During the COVID-19 Pandemic

Jan. 14, 2021

Ari B. Friedman, Deidre Barfield, Guy David, Thomas Diller, Candace Gunnarson, Miao Liu, Benjamin V. Vicidomina, Ruthann Zhang, Yuan Zhang, Somesh C. Nigam

Abstract [from journal]

Importance: COVID-19 has been associated with excess mortality among patients not diagnosed with COVID-19, suggesting disruption of acute health care provision may play a role.

Objective: To determine the degree of declines in emergency department (ED) visits attributable to COVID-19 and determine whether these declines were concentrated among patients with fewer comorbidities and lower severity visits.

Design: We conducted a differences-in-differences analysis of all


Bringing Gynecologic Cancer Care Closer to Patients

Jan. 13, 2021

For patients with gynecologic cancers, treatment by a specialist—a gynecologic oncologist—is crucial for improving chances of survival. However, in 2015, as many as 10% of women in the U.S. lived in a county that was more than 50 miles from the closest gynecologic oncologist.

Patients’ and Caregivers’ Perspectives in Determining Discharge Readiness From Home Health

Jan. 11, 2021

Melissa O'Connor, Helene Moriarty, Anne Schneider, Elizabeth B. Dowdell, Kathryn H. Bowles

Abstract [from journal]

There are no national, empirically derived clinical decision support tools to assist the interprofessional home health team in determining readiness for discharge from skilled home health. Eliciting patient and family caregiver perspectives around readiness for home health discharge is integral to developing tools that address their needs in this decision-making process. The purpose of this study was to describe the factors home health patients and their family caregivers perceive as critical when determining readiness for discharge