Department of Ophthalmology and Visual Sciences, University of Michigan Medical School; Kellogg Eye Center for Eye Policy and Innovation and applies to ARE, CAA, LBD, MAW, PPL and PANC.
Department of Ophthalmology and Visual Sciences, University of Michigan Medical School.
Am J Ophthalmol. 2022 Jan;233:163-170. doi: 10.1016/j.ajo.2021.07.024. Epub 2021 Jul 26.
To assess the relationship between telemedicine utilization and sociodemographic factors among patients seeking eye care.
Comparative utilization analysis.
We reviewed the eye care utilization patterns of a stratified random sample of 1720 patients who were seen at the University of Michigan Kellogg Eye Center during the height of the COVID-19 pandemic (April 30 to May 25, 2020) and their odds of having a video, phone, or in-person visit compared with having a deferred visit. Associations between independent variables and visit type were determined using a multinomial logistic regression model.
Older patients had lower odds of having a video visit (P = .007) and higher odds of having an in-person visit (P = .023) compared with being deferred, and in the nonretina clinic sample, older patients still had lower odds of a video visit (P = .02). Non-White patients had lower odds of having an in-person visit (P < .02) in the overall sample compared with being deferred, with a similar trend seen in the retina clinic. The mean neighborhood median household income was $76,200 (±$33,500) and varied significantly (P < .0001) by race with Blacks having the lowest estimated mean income.
Disparities exist in how patients accessed eye care during the COVID-19 pandemic with older patients-those for whom COVID-19 posed a higher risk of mortality-being more likely to be seen for in-person care. In our affluent participant sample, there was a trend toward non-White patients being less likely to access care. Reimbursing telemedicine solely through broadband internet connection may further exacerbate disparities in eye care.
评估远程医疗利用与寻求眼科护理的患者社会人口因素之间的关系。
比较利用分析。
我们回顾了在 COVID-19 大流行高峰期（2020 年 4 月 30 日至 5 月 25 日）在密歇根大学凯洛格眼科中心就诊的 1720 名患者的分层随机样本的眼保健利用模式，以及他们与推迟就诊相比进行视频、电话或亲自就诊的几率。使用多项逻辑回归模型确定自变量与就诊类型之间的关联。
与推迟就诊相比，老年患者进行视频就诊的几率较低（P=0.007），进行面对面就诊的几率较高（P=0.023），而非视网膜诊所样本中，老年患者进行视频就诊的几率仍然较低（P=0.02）。与推迟就诊相比，非白人患者在总体样本中进行面对面就诊的几率较低（P<0.02），在视网膜诊所中也存在类似趋势。邻里中位数家庭收入的平均值为 76200 美元（±33500 美元），按种族差异显著（P<0.0001），黑人的估计平均收入最低。
在 COVID-19 大流行期间，患者获得眼科护理的方式存在差异，死亡率较高的老年患者更有可能接受面对面护理。在我们富裕的参与者样本中，非白人患者获得护理的可能性呈下降趋势。仅通过宽带互联网连接来补偿远程医疗可能会进一步加剧眼科护理的差异。
