Time to Treatment of Pediatric Retinal Detachments: A US Claims-based Analysis.

Autor:	Archambault C; Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California., Azad AD; Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California., Al-Moujahed A; Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California., Vail D; Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California., Wood E; Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California., Koo EB; Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California. Electronic address: eunakoo@stanford.edu.
Jazyk:	angličtina
Zdroj:	Ophthalmology. Retina [Ophthalmol Retina] 2023 Mar; Vol. 7 (3), pp. 221-226. Date of Electronic Publication: 2022 Aug 21.
DOI:	10.1016/j.oret.2022.08.017
Abstrakt:	Purpose: To characterize delays in diagnosis and treatment of retinal detachments (RDs) in a pediatric population. Design: Retrospective cohort study using insurance claims data. Subjects: Pediatric patients with RD who underwent repair in the outpatient setting. Methods: A retrospective analysis of commercially insured patients from a national cohort (IBM MarketScan Research Databases) aged ≤ 18 years with an incident diagnosis of RD between 2007 and 2016. Patients with preceding eye-related visits, time to diagnosis, and time to repair were calculated and compared between patients with pre-existing ocular diagnosis and those without. Main Outcome Measures: The time from diagnosis to specialist consultation, time from diagnosis to repair, time from specialist consultation to repair, number of preceding visits, and presence of previous eye-related diagnosis. Results: Our sample consisted of 826 patients, the majority (77%) of whom were diagnosed with rhegmatogenous RD. Only 40% of patients had at least 1 preceding eye-related visit, and 33% had at least 2 visits before RD diagnosis, with a median time from the last eye-related visit of 32 days (4-197 days) and median time from the second to last visit of 118 days (24-437 days). The median time from RD diagnosis to repair was 2 days (0-9 days). The 323 (37.9%) patients with pre-existing ocular diagnoses more frequently had at least 1 (44% vs. 37%; P = 0.079) or 2 preceding eye-related visits (40% vs. 29%; P = 0.002) compared with those without and also had a shorter time to RD diagnosis (median, 14.5 days vs. 44.5 days; P = 0.011) and repair (1 day vs. 3 days; P = 0.003). Conclusions: Retinal detachment is an important cause of morbidity in children. This work highlighted how pediatric patients without previous ocular diagnoses and visits with eye care professional may have a delayed diagnosis and repair of their RD. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references. (Copyright © 2022 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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