Ashrafzadeh Sahar, Gundlach Bradley S, Tsui Irena
David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Ophthalmology Department, West Los Angeles Veterans Health Administration, Los Angeles, CA, USA.
Clin Ophthalmol. 2021 Aug 28;15:3661-3668. doi: 10.2147/OPTH.S314840. eCollection 2021.
Early on in the COVID-19 pandemic, it was difficult to know what factors would affect patient and physician decision-making regarding ophthalmic care utilization. The purpose of this study is to investigate the effect of non-ophthalmic factors on patient decision-making to receive intravitreal injections during the COVID-19 lockdown.
Data on patients who had intravitreal injection appointments at a tertiary care Veterans Health Administration clinic during a seven-week period (March 19, 2020-May 8, 2020) of the COVID-19 outbreak in Los Angeles County were collected and compared to patients who had intravitreal injection appointments during the same time period in 2019. Demographic characteristics, injection diagnoses, visual acuities, body mass indices, co-morbidities, and psychiatric conditions of patients and clinic volumes were tabulated and compared between the two time periods.
There were 86 patients in the injection clinic in 2020 compared to 176 patients in 2019. The mean age and gender of patients in the injection clinic did not differ between 2019 and 2020. Compared to 2019, the number of patients who identified as Hispanic or Latino remained nearly the same, but the number of patients who identified as White, Black, or Asian or Pacific Islander decreased by nearly half. In 2020, a greater proportion of patients came to the injection clinic for neovascular age-related macular degeneration (56.5% vs 39.3%, p=0.017), but a decreased proportion of patients diagnosed with a heart condition (OR 0.57, 95% CI 0.33, 0.96), chronic obstructive pulmonary disease (OR 0.43, 95% CI 0.21, 0.91), or asthma (OR 0.09, 95% CI 0.01, 0.70) came to the injection clinic.
The COVID-19 pandemic was associated with behavioral changes in eyecare utilization influenced by race and systemic co-morbidities. These data can be used to design and implement strategies to address disparities in essential ophthalmic care among vulnerable populations.
在新冠疫情早期，很难知晓哪些因素会影响患者和医生在眼科护理利用方面的决策。本研究的目的是调查在新冠疫情封锁期间非眼科因素对患者接受玻璃体内注射决策的影响。
收集了在洛杉矶县新冠疫情爆发的七周期间（2020年3月19日至2020年5月8日）在一家三级医疗退伍军人健康管理局诊所进行玻璃体内注射预约的患者数据，并与2019年同期进行玻璃体内注射预约的患者进行比较。列出并比较了两个时间段患者的人口统计学特征、注射诊断、视力、体重指数、合并症、精神状况以及诊所就诊量。
2020年注射诊所中有86名患者，而2019年有176名患者。2019年和2020年注射诊所患者的平均年龄和性别没有差异。与2019年相比，自称西班牙裔或拉丁裔的患者数量几乎保持不变，但自称白人、黑人或亚裔或太平洋岛民的患者数量减少了近一半。2020年，因新生血管性年龄相关性黄斑变性前来注射诊所的患者比例更高（56.5%对39.3%，p = 0.017），但被诊断患有心脏病（OR 0.57，95% CI 0.33，0.96）、慢性阻塞性肺疾病（OR 0.43，95% CI 0.21，0.91）或哮喘（OR 0.09，95% CI 0.01，0.70）的患者前来注射诊所的比例下降。
新冠疫情与受种族和全身合并症影响的眼科护理利用行为变化有关。这些数据可用于设计和实施策略来解决弱势群体在基本眼科护理方面的差异。
