Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children and University of Toronto, Toronto, Canada.
University of Toronto, Institute of Medical Sciences, Toronto, Canada.
Transl Vis Sci Technol. 2023 Nov 1;12(11):36. doi: 10.1167/tvst.12.11.36.
To characterize the availability of social determinants of health data in the electronic health record of pediatric ophthalmology patients and to examine the association of social determinants of health with attendance at scheduled operating room and clinic visits.
This was a retrospective cohort study of pediatric ophthalmology patients seen at The Hospital for Sick Children between June 1, 2018, and May 23, 2022. Data were collected on demographics, diagnosis, and management-plan. The χ2 tests and multivariable regression were used to examine associations between social determinants of health and attendance at scheduled operating room and clinic visits.
The cohort consisted of 26,102 study subjects with 31,288 unique eye-related diagnoses representing 57 unique ICD-10 codes. Availability of data in the electronic health record ranged from 100% for sex, age and postal code to 0.1% for ethnic group. Female sex (P = 0.004) and urbanicity (P = 0.05) were associated with higher operating room visit cancellations. Female sex (P = 0.002), age group 0-13 (P ≤ 0.001), low-medium neighborhood income quintile (P ≤ 0.001), residence of Northern Ontario (P ≤ 0.001), and urbanicity (P ≤ 0.001) were associated with higher clinic visit cancellations and no-shows.
At a major tertiary-care hospital in Canada, key social determinant data such as ethnicity are not consistently available in the electronic health record of pediatric ophthalmology patients. Female sex, younger age, and living in a rural area or neighborhood with low-medium income quintile may be predictors of missed visits and require further study.
This study highlights a need for improved documentation of social determinants of health variables in electronic health records.
描述儿科眼科学患者电子健康记录中社会决定因素健康数据的可用性，并研究社会决定因素健康与预约手术室和诊所就诊的关系。
这是一项回顾性队列研究，纳入 2018 年 6 月 1 日至 2022 年 5 月 23 日期间在 SickKids 医院就诊的儿科眼科学患者。收集人口统计学、诊断和管理计划数据。使用卡方检验和多变量回归分析社会决定因素健康与预约手术室和诊所就诊的关系。
该队列包括 26102 名研究对象，有 31288 个独特的眼部相关诊断，代表 57 个独特的 ICD-10 代码。电子健康记录中数据的可用性从 100%（性别、年龄和邮政编码）到 0.1%（种族）不等。女性性别（P=0.004）和城市化程度（P=0.05）与更高的手术室就诊取消率相关。女性性别（P=0.002）、0-13 岁年龄组（P≤0.001）、中低收入五分位数街区（P≤0.001）、安大略省北部居住（P≤0.001）和城市化程度（P≤0.001）与更高的诊所就诊取消率和失约相关。
在加拿大的一家主要三级保健医院，儿科眼科学患者的电子健康记录中没有一致提供关键的社会决定因素数据，如种族。女性性别、年龄较小、居住在农村地区或中低收入五分位数街区可能是错过就诊的预测因素，需要进一步研究。
本研究强调了在电子健康记录中改进社会决定因素健康变量记录的必要性。
