Chuter Benton G, Lieu Alexander, Dayao John Kevin O, Bu Jennifer J, Chen Kevin, Nishihara Taiki, Baxter Sally L
School of Medicine, University of California San Diego, La Jolla, California, USA.
Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, USA.
J Stud Run Clin. 2022 Dec 20;8(1). Epub 2022 Nov 16.
Diabetic retinopathy is the leading cause of blindness among working-age adults in the United States and requires timely screening and management. This study evaluates the impact of the coronavirus disease 2019 (COVID-19) pandemic on diabetic retinopathy screening (DRS) for uninsured, predominantly Latino patients at the University of California San Diego Student-Run Free Clinic Project (SRFCP).
A retrospective chart review was conducted of all living diabetic patients at SRFCP who were seen in 2019 (n=196), 2020 (n=183), and 2021 (n=178). Ophthalmology clinic referrals, scheduled patient visits, and visit outcomes were analyzed longitudinally to determine the impact of the pandemic on screening patterns.
The study population was 92.1% Latino, 69.5% female, with a mean age of 58.7 years. The distribution of patients seen (p<0.001), referred (p=0.012), and scheduled (p<0.001) in 2020 and 2021 significantly differed from 2019. In 2019, 50.5% of 196 patients eligible for DRS were referred, 49.5% were scheduled, and 45.4% were seen. In 2020, 41.5% of 183 eligible patients were referred, but only 20.2% were scheduled and 11.4% were seen. In 2021, there was a rebound: 63.5% of 178 patients were referred, 56.2% scheduled and 46.1% seen. No shows and cancellations represented 12.4% and 6.2% of the 97 encounters scheduled in 2019, but were markedly higher (10.8% and 40.5% respectively) for the 37 encounters scheduled in 2020.
The COVID-19 pandemic significantly impacted the delivery of eye care at SRFCP. The need for annual DRS exceeded the capacity of the ophthalmology clinic in all years studied, but the difference was especially pronounced with more stringent COVID-19 restrictions in 2020. SRFCP patients could benefit from telemedicine DRS programs to improve screening capacity.
糖尿病视网膜病变是美国劳动年龄成年人失明的主要原因，需要及时进行筛查和管理。本研究评估了2019年冠状病毒病（COVID-19）大流行对加利福尼亚大学圣地亚哥分校学生运营免费诊所项目（SRFCP）中未参保、主要为拉丁裔患者的糖尿病视网膜病变筛查（DRS）的影响。
对SRFCP在2019年（n = 196）、2020年（n = 183）和2021年（n = 178）就诊的所有在世糖尿病患者进行回顾性病历审查。纵向分析眼科诊所转诊、预定患者就诊及就诊结果，以确定大流行对筛查模式的影响。
研究人群中92.1%为拉丁裔，69.5%为女性，平均年龄58.7岁。2020年和2021年就诊（p < 0.001）、转诊（p = 0.012）和预定（p < 0.001）的患者分布与2019年显著不同。2019年，196名符合DRS条件的患者中，50.5%被转诊，49.5%被预定，45.4%就诊。2020年，183名符合条件的患者中，有41.5%被转诊，但只有20.2%被预定，11.4%就诊。2021年出现反弹：178名患者中有63.5%被转诊，56.2%被预定并46.1%就诊。未就诊和取消就诊分别占2019年预定的97次就诊的12.4%和6.2%，但在2020年预定的37次就诊中显著更高（分别为10.8%和40.5%）。
COVID-19大流行显著影响了SRFCP的眼科护理服务。在所研究的所有年份中，年度DRS的需求均超过了眼科诊所的能力，但在2020年COVID-19限制更为严格时差异尤为明显。SRFCP患者可受益于远程医疗DRS项目以提高筛查能力。
