Banks James, Olvera-Barrios Abraham, Pitt Matilda, Williams Daisy, Seltene Michael, Rutowska Celestine, Khatun Mumina, Huemer Josef, Khan Yasir, Ockrim Zoe, Heng Ling Zhi, Rudnicka Alicja R, Tufail Adnan, A Egan Catherine, Owen Christopher G
Population Health Research Institute, City St George's, University of London , London, UK.
Medical Retina, Moorfields Eye Hospital NHS Foundation Trust, London, UK.
BMJ Open Ophthalmol. 2025 Jan 22;10(1):e001969. doi: 10.1136/bmjophth-2024-001969.
BACKGROUND/AIMS: To examine the association between sociodemographic characteristics and attendance at Hospital Eye Service (HES) referrals from the Diabetic Eye Screening Programme (DESP), in a large, ethnically diverse urban population.
Retrospective cohort study (4 January 2016-12 August 2019) of people with diabetic retinopathy (DR) referred from an English DESP to a tertiary referral eye hospital. We conducted a multivariable logistic regression with attendance as the primary outcome, controlling for age, sex, ethnicity, Index of Multiple Deprivation, best eye visual acuity and baseline DR grade.
Of 7793 people referred (mean age 64 years, 62.6% male, 13.9% white, 12.5% black, 25.3% South Asian, 6.5% any other Asian background, 19.3% no recorded ethnicity and 20.9% of 'Other' ethnic origin), 69% attended. Compared with white individuals, people of black ethnic origin were similarly likely to attend. South Asians and those of other Asian backgrounds were more likely, and people with 'Other' or missing ethnicity were less likely to attend. Those with higher levels of deprivation, younger (aged 18-45 years) and older (76-90 years) age groups and worse visual acuity were less likely to attend, whereas people identified as having proliferative DR in both eyes were more likely to attend.
Sociodemographic patterns in attendance after referral from the DESP to the HES exist, and these do not appear to explain ethnic differences in more severe sight-threatening DR, suggesting other explanations. More work is needed to understand and reduce inequalities in HES attendance.
背景/目的：在一个种族多样化的大型城市人口中，研究社会人口学特征与糖尿病眼病筛查项目（DESP）转诊至医院眼科服务（HES）的就诊率之间的关联。
对从英国DESP转诊至三级转诊眼科医院的糖尿病视网膜病变（DR）患者进行回顾性队列研究（2016年1月4日至2019年8月12日）。我们进行了多变量逻辑回归分析，以就诊情况作为主要结局，同时控制年龄、性别、种族、多重剥夺指数、最佳矫正视力和基线DR分级。
在7793名被转诊的患者中（平均年龄64岁，男性占62.6%，白人占13.9%，黑人占12.5%，南亚人占25.3%，其他亚洲背景占6.5%，19.3%未记录种族，20.9%为“其他”族裔），69%的患者就诊。与白人相比，黑人族裔的患者就诊可能性相似。南亚人和其他亚洲背景的人就诊可能性更高，而“其他”族裔或种族信息缺失的人就诊可能性较低。贫困程度较高、年龄较轻（18 - 45岁）和较大（76 - 90岁）的年龄组以及视力较差的患者就诊可能性较低，而双眼均被诊断为增殖性DR的患者就诊可能性较高。
从DESP转诊至HES后的就诊情况存在社会人口学模式，但这些模式似乎无法解释在更严重的威胁视力的DR方面的种族差异，提示存在其他解释。需要开展更多工作来理解和减少HES就诊方面的不平等现象。
