Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas; and.
Retina. 2023 Nov 1;43(11):1936-1944. doi: 10.1097/IAE.0000000000003897.
BACKGROUND/PURPOSE: Within the evolving landscape of healthcare in the United States (US), delineating the demographic nuances and financial implications of emergent conditions, such as rhegmatogenous retinal detachment (RRD), is paramount. This study seeks to analyze the demographic and hospital billing amount/cost of service disparities in RRD visits to emergency departments (EDs) nationwide.
We conducted a retrospective, cross-sectional, population-based study using International Classification of Diseases, 10th revision , and Current Procedural Terminology codes in the 2016 to 2019 Nationwide Emergency Department Sample databases to identify RRD visits. The analysis included demographics, hospital billing amount, and cost of service of RRD ED management.
A total of 12,492 RRD encounters were identified with men constituting 64% and a prominent age group being 50 to 64 years (49.3%). Most patients (90%) were managed in metropolitan teaching hospitals, predominantly in the southern U.S. region (56.1%). Private insurance covered 45% of patients. Same-day RRD repair odds increased in November and December. Whites had a higher likelihood for same-day treatment. Hospital billing amount rose from $23,600 in 2016 to $30,354 in 2019, with stable mean total cost of service. Rhegmatogenous retinal detachment ED visit incidence did not show seasonal variation ( P = 0.819).
Most patients with RRD in U.S, EDs were middle-aged men, with Whites more likely to receive same-day repair. There was no sex bias observed in same-day repair decision-making. Although hospital billing amount increased over the study period, total cost of service remained stable. The incidence of RRD ED visits showed no seasonal variation.
背景/目的：在美国（US）不断发展的医疗保健领域，描绘新兴病症（如孔源性视网膜脱离（RRD））的人口统计学细节和财务影响至关重要。本研究旨在分析全国急诊部（ED）RRD就诊的人口统计学和医院计费金额/服务成本差异。
我们使用 2016 年至 2019 年全国急诊部抽样数据库中的国际疾病分类第 10 版和当前程序术语代码进行回顾性、横断面、基于人群的研究，以确定 RRD 就诊。分析包括 RRD ED 管理的人口统计学、医院计费金额和服务成本。
共确定了 12492 例 RRD 就诊，其中男性占 64%，年龄较大的群体为 50 至 64 岁（49.3%）。大多数患者（90%）在大都市教学医院接受治疗，主要集中在美国南部地区（56.1%）。私人保险覆盖了 45%的患者。RRD 修复的当日手术几率在 11 月和 12 月增加。白人更有可能接受当日治疗。医院计费金额从 2016 年的 23600 美元增加到 2019 年的 30354 美元，而平均总成本保持稳定。RRD ED 就诊的发生率没有季节性变化（P=0.819）。
美国 ED 中大多数 RRD 患者为中年男性，白人更有可能接受当日修复。在当日修复决策中没有观察到性别偏见。尽管研究期间医院计费金额有所增加，但总服务成本保持稳定。RRD ED 就诊的发生率没有季节性变化。
