A Retrospective Study of Disparities in an Academic Ophthalmic Emergency Department.
| Autor: | Szypko C; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.; New York Institute of Technology College of Osteopathic Medicine, Old Westbury, New York., Hall N; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts., Ta T; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts., Gardiner MF; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts., Lorch AC; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Journal of academic ophthalmology (2017) [J Acad Ophthalmol (2017)] 2021 Dec 25; Vol. 13 (2), pp. e277-e287. Date of Electronic Publication: 2021 Dec 25 (Print Publication: 2021). |
| DOI: | 10.1055/s-0041-1736439 |
| Abstrakt: | Purpose Emergency medicine is a common access point to health care; disparities in this care by demographic characteristics, including race and ethnicity, may affect outcomes. The Massachusetts Eye and Ear (MEE) Emergency Department (ED) is a subspecialty emergency department; data from this site can be utilized to better understand social determinants of quality ophthalmic care. Design This is a retrospective cross sectional cohort study in the MEE ED examining patient visits from June 1, 2016 to June 30, 2019. Methods Using the electronic medical record system, all unique visits were identified between June 1, 2016 and June 30, 2019 (inclusive); patient demographics (sex, race, ethnicity [Hispanic vs. non-Hispanic], primary care provider [PCP] status, insurance type, zip code, primary language), date of visit, triage category and outcomes (final diagnosis, visit duration, and next visit at MEE within 3 months of the ED visit) were collected. Kaplan-Meier plots were used to visualize likelihood of follow-up visit to MEE for urgent patients based on demographics. Multivariate linear regression was used to examine factors affecting visit durations, as stratified by urgency, and Cox proportional hazards regression was used to establish hazard ratios for next visit to MEE. Results Of the 46,248 ophthalmology ED initial visits, only triage status, season of visit, out-of-state residency, Medicare coverage, and Medicaid coverage led to statistically significant differences in visit durations for urgent visits compared with the respective reference groups. Similar trends persisted within the non-urgent visit cohort for visit durations. Residency, insurance coverage, season of visit, race, PCP status, and sex were identified as statistically significant predictors of the likelihood of a follow-up visit. Conclusion Data from an ophthalmic emergency department suggest that demographic factors do impact patient visit duration and time to follow-up visit. These findings suggest a continued need for attention to social determinants of health and equitable care of patients within ophthalmology. Competing Interests: Conflict of Interest Dr. Matthew Gardiner receives royalties for contributions to UpToDate. (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).) |
| Databáze: | MEDLINE |
| Externí odkaz: |
|