Department of Biomedical Informatices, University of California San Diego, San Diego, California, USA.
Department of Ophthalmology, Stanford University, Stanford, California, USA.
Ophthalmic Epidemiol. 2024 Feb;31(1):21-30. doi: 10.1080/09286586.2023.2180807. Epub 2023 Feb 20.
To compare disparities in outpatient ophthalmic care during early and later periods of the COVID-19 public health emergency.
This cross-sectional study compared non-peri-operative outpatient ophthalmology visits by unique patients at an adult ophthalmology practice affiliated with a tertiary-care academic medical center in the Western US during three time periods: pre-COVID (3/15/19-4/15/19), early-COVID (3/15/20-4/15/20), and late-COVID (3/15/21-4/15/21). Differences in participant demographics, barriers to care, visit modality (telehealth, in person), and subspeciality of care were studied using unadjusted and adjusted models.
There were 3095, 1172 and 3338 unique patient-visits during pre-COVID, early-COVID and late-COVID (overall age 59.5 ± 20.5 years, 57% female, 41.8% White, 25.9% Asian, 16.1% Hispanic). There were disparities in patient age (55.4 ± 21.8 vs. 60.2 ± 19.9 years), race (21.9% vs. 26.9% Asian), ethnicity (18.3% Hispanic vs. 15.2% Hispanic), and insurance (35.9% vs. 45.1% Medicare) as well as changes in modality (14.2% vs. 0% telehealth) and subspecialty (61.6% vs. 70.1% internal exam specialty) in early-COVID vs. pre-COVID (p < .05 for all). In late-COVID, only insurance (42.7% vs. 45.1% Medicare) and modality of care (1.8% vs. 0% telehealth) persisted as differences compared to pre-COVID.
There were disparities in patients receiving outpatient ophthalmology care during early-COVID that returned close to pre-COVID baseline one year later. These results suggest that there has not been a lasting positive or negative disruptive effect of the COVID-19 pandemic on disparities in outpatient ophthalmic care.
比较 COVID-19 公共卫生紧急事件早期和后期门诊眼科护理的差异。
本横断面研究比较了美国西部一家三级保健学术医疗中心附属成人眼科诊所的独特患者在三个时期的非手术门诊眼科就诊情况：COVID-19 前（2019 年 3 月 15 日至 4 月 15 日）、COVID-19 早期（2020 年 3 月 15 日至 4 月 15 日）和 COVID-19 后期（2021 年 3 月 15 日至 4 月 15 日）。使用未调整和调整后的模型研究了参与者人口统计学特征、护理障碍、就诊方式（远程医疗、面对面）和护理专业的差异。
COVID-19 前、COVID-19 早期和 COVID-19 后期的独特患者就诊次数分别为 3095 次、1172 次和 3338 次（总体年龄 59.5 ± 20.5 岁，女性占 57%，白人占 41.8%，亚裔占 25.9%，西班牙裔占 16.1%）。患者年龄（55.4 ± 21.8 岁 vs. 60.2 ± 19.9 岁）、种族（21.9% vs. 26.9%亚裔）、族裔（18.3%西班牙裔 vs. 15.2%西班牙裔）和保险（35.9% vs. 45.1%医疗保险）存在差异，就诊方式（14.2% vs. 0%远程医疗）和专科（61.6% vs. 70.1%内科检查专科）也存在差异，COVID-19 早期与 COVID-19 前相比（所有 p < 0.05）。在 COVID-19 后期，与 COVID-19 前相比，只有保险（42.7% vs. 45.1%医疗保险）和护理方式（1.8% vs. 0%远程医疗）仍然存在差异。
在 COVID-19 早期，接受门诊眼科护理的患者存在差异，一年后接近 COVID-19 前的基线水平。这些结果表明，COVID-19 大流行对门诊眼科护理差异没有产生持久的积极或消极的破坏性影响。
