2021
The potential impact of triage protocols on racial disparities in clinical outcomes among COVID-positive patients in a large academic healthcare system
Roy S, Showstark M, Tolchin B, Kashyap N, Bonito J, Salazar MC, Herbst JL, Nash KA, Tiako M, Jubanyik K, Kim N, Galusha D, Wang KH, Oladele C. The potential impact of triage protocols on racial disparities in clinical outcomes among COVID-positive patients in a large academic healthcare system. PLOS ONE 2021, 16: e0256763. PMID: 34529684, PMCID: PMC8445412, DOI: 10.1371/journal.pone.0256763.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overBlack or African AmericanConnecticutCOVID-19Delivery of Health CareFemaleHealthcare DisparitiesHispanic or LatinoHospital MortalityHospitals, UniversityHumansMaleMiddle AgedOrgan Dysfunction ScoresPandemicsRetrospective StudiesSARS-CoV-2TriageWhite PeopleYoung AdultConceptsCOVID-positive patientsHigher SOFA scoreSOFA scoreClinical outcomesBlack patientsHospital mortalityICU admissionTriage protocolYale New Haven Health SystemSequential Organ Failure Assessment scoreHealthcare systemLarge academic healthcare systemOrgan Failure Assessment scoreRacial disparitiesSimilar clinical outcomesWorse clinical outcomesAcademic healthcare systemChi-square testRace/ethnicityPredictors of interestRetrospective cohortWhite patientsInsurance statusCOVID patientsTriage tool
2020
Developing a Triage Protocol for the COVID-19 Pandemic: Allocating Scarce Medical Resources in a Public Health Emergency.
Tolchin B, Latham SR, Bruce L, Ferrante LE, Kraschel K, Jubanyik K, Hull SC, Herbst JL, Kapo J, Moritz ED, Hughes J, Siegel MD, Mercurio MR. Developing a Triage Protocol for the COVID-19 Pandemic: Allocating Scarce Medical Resources in a Public Health Emergency. The Journal Of Clinical Ethics 2020, 31: 303-317. PMID: 32991327, DOI: 10.1086/jce2020314303.Peer-Reviewed Original ResearchConceptsPublic health emergencyTriage protocolScarce medical resourcesYale New Haven Health SystemMedical resourcesEthical challengesHealth emergencyCOVID-19 pandemicAllocating Scarce Medical ResourcesFuture wavesMajor ethical challengesChronic comorbiditiesPregnant patientsSimilar public health emergenciesHealthcare workersTriage assessmentClinical judgmentCoronavirus diseaseHealth systemSocioeconomic disparitiesRole of ageCOVID-19Less needPublic discussionSecondary goalTriage and justice in an unjust pandemic: ethical allocation of scarce medical resources in the setting of racial and socioeconomic disparities
Tolchin B, Hull SC, Kraschel K. Triage and justice in an unjust pandemic: ethical allocation of scarce medical resources in the setting of racial and socioeconomic disparities. Journal Of Medical Ethics 2020, 47: 200-202. PMID: 33067315, DOI: 10.1136/medethics-2020-106457.Peer-Reviewed Original ResearchBroader social changeEntrenched health disparitiesLife-saving medical resourcesSystemic health inequitiesTriage protocolHealth disparitiesMedical resourcesSocial changeStructural racismSystemic inequitiesScarce medical resourcesHealth inequitiesComparative advantagePublic health emergencyEthical challengesSocioeconomic health disparitiesInequitiesCrisis standardsTriage systemSocioeconomic disparitiesAdequate mechanismsHealth emergencyEthical allocationHealthcare systemDisparities