Ramsey David J, Lasalle Claudia C, Anjum Sidrah, Marx Jeffrey L, Roh Shiyoung
Department of Surgery, Division of Ophthalmology, Lahey Hospital & Medical Center, Beth Israel Lahey Health, Burlington, MA, 01805, USA.
Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, 02111, USA.
Clin Ophthalmol. 2022 Jul 4;16:2157-2166. doi: 10.2147/OPTH.S368972. eCollection 2022.
The COVID-19 pandemic had a disproportionate impact on patients from racial and/or ethnic minority groups, causing many to delay healthcare. This study evaluates the role telehealth visits played in helping patients with diabetes mellitus (DM) return for subsequent, in-person eye examinations after the outbreak of COVID-19.
This retrospective, cross-sectional study analyzed 8147 patients with DM who had completed an outpatient ophthalmology and/or optometry visit in 2019 and who were due for return evaluation after the outbreak of COVID-19 in 2020. Factors associated with return for subsequent, in-person eye examination were assessed.
The mean age of patients was 68.8 (±13.0) years, and 42% were women. 7.4% of patients identified as Asian; 2.9% as Black; 3.4% as Hispanic or Latin American; 0.92%, as more than one race; 1.78%, as other races; and 80.7% as White. Patients from racial and/or ethnic minority groups completed fewer in-person eye examinations after the outbreak of COVID-19 compared with White patients (35.6% versus 44.5%, =36.172, <0.001). However, both groups accessed telehealth services at a similar rate during this period (21.1% versus 21.9%, =0.417, =0.518). Importantly, patients who received telehealth services returned for subsequent, in-person eye examinations at substantially higher rates, regardless of race (51.0% and 46.6%, respectively, =1.840, =0.175). This offset the otherwise lower rate of return experienced by patients from racial and/or ethnic minority groups compared with White patients among the group of patients who did not receive any telehealth services (32.7% versus 42.7%, =36.582, <0.001). The impact of telehealth on the likelihood of in-person return remained significant after taking into account age, gender, race, language, residence, severity of diabetic retinopathy (DR), and vision in a multivariate model.
Telehealth initiatives benefited patients from racial and/or ethnic minority groups by reducing disparities in access to eye care experienced during the COVID-19 pandemic.
新冠疫情对种族和/或少数民族患者产生了不成比例的影响，导致许多人推迟医疗保健。本研究评估了远程医疗就诊在帮助糖尿病（DM）患者在新冠疫情爆发后返回进行后续面对面眼科检查方面所起的作用。
这项回顾性横断面研究分析了8147例在2019年完成门诊眼科和/或验光就诊且在2020年新冠疫情爆发后应进行复诊评估的DM患者。评估了与返回进行后续面对面眼科检查相关的因素。
患者的平均年龄为68.8（±13.0）岁，42%为女性。7.4%的患者为亚洲人；2.9%为黑人；3.4%为西班牙裔或拉丁裔；0.92%为多种族；1.78%为其他种族；80.7%为白人。与白人患者相比，种族和/或少数民族患者在新冠疫情爆发后完成的面对面眼科检查较少（35.6%对44.5%，χ² = 36.172，P < 0.001）。然而，在此期间两组使用远程医疗服务的比例相似（21.1%对21.9%，χ² = 0.417，P = 0.518）。重要的是，接受远程医疗服务的患者返回进行后续面对面眼科检查的比例显著更高，无论种族如何（分别为51.0%和46.6%，χ² = 1.840，P = 0.175）。这抵消了在未接受任何远程医疗服务的患者组中，种族和/或少数民族患者与白人患者相比原本较低的复诊率（32.7%对42.7%，χ² = 36.582，P < 0.001）。在多变量模型中考虑年龄、性别、种族、语言、居住地、糖尿病视网膜病变（DR）严重程度和视力后，远程医疗对面对面复诊可能性的影响仍然显著。
远程医疗举措通过减少新冠疫情期间在获得眼科护理方面的差异，使种族和/或少数民族患者受益。
