Scott Nathan, Wedekind Lauren, Chen Jimmy, Sestak Timothy, Sigua Logan, Yap Jazmyn, Lin Sidney, Kalaw Fritz Gerald, Marra Kyle, Lee Jeffrey
Shiley Eye Institute, University of California San Diego.
University of California San Diego.
Res Sq. 2025 Apr 21:rs.3.rs-6050144. doi: 10.21203/rs.3.rs-6050144/v1.
BACKGROUND/OBJECTIVES: Ophthalmic care for patients who are incarcerated or in immigration detention presents complex challenges for patients and providers. There remains a paucity of literature investigating ophthalmic care for these marginalised populations. We investigated delivery of ophthalmic care in an academic health system to patients who were incarcerated or in immigration detention.
SUBJECTS/METHODS: We conducted a retrospective observational study and secondary analysis of electronic health record data for inpatient, outpatient, and surgical visits between 1 November 2018 and 30 September 2023 in an ophthalmology department at an academic medical centre in the United States for patients who were incarcerated or in immigration detention. Attendance at outpatient clinic visits and follow-up based on ophthalmic subspecialty, loss to follow-up, delays in follow-up, rates of ancillary testing were analysed.
1628 visits were extracted for 401 patients, for which 1084 were attended [2.7 ± 3.6 per patient] and 544 were canceled or no-showed [1.4 ± 1.8 per patient]. Patients attended 100 [68.5%] of cornea, 116 [64.4%] of glaucoma, 2 [28.6%] of neuro-ophthalmology, 139 [58.2%] oculoplastics, 9 [36.0%] of paediatrics/strabismus, and 109 [54.5%] of retina visits. Using a 2-week grace period for follow-up, 72 patients (40.9% with complete follow-up data) completed follow-up within 2 weeks. 229 patients (57.1%) were lost to follow-up at the end of the study period.
Delays in care and visit attrition were substantial for patients who were incarcerated or in immigration detention. More work is needed to quantify outcomes and address disparities in care for these marginalised communities.
背景/目的：为被监禁或处于移民拘留状态的患者提供眼科护理，对患者和医护人员来说都面临着复杂的挑战。目前针对这些边缘化人群的眼科护理研究文献仍然匮乏。我们调查了在一个学术医疗系统中为被监禁或处于移民拘留状态的患者提供眼科护理的情况。
对象/方法：我们进行了一项回顾性观察研究，并对2018年11月1日至2023年9月30日期间在美国一家学术医疗中心眼科部门进行住院、门诊和手术就诊的被监禁或处于移民拘留状态患者的电子健康记录数据进行了二次分析。分析了门诊就诊的出勤率、基于眼科亚专业的随访情况、失访情况、随访延迟情况以及辅助检查率。
提取了401名患者的1628次就诊记录，其中1084次就诊有人参加[每位患者2.7±3.6次]，544次就诊被取消或未出现[每位患者1.4±1.8次]。患者参加了角膜科就诊的100次[68.5%]、青光眼科就诊的116次[64.4%]、神经眼科就诊的2次[28.6%]、眼整形科就诊的139次[58.2%]、儿科/斜视就诊的9次[36.0%]以及视网膜科就诊的109次[54.5%]。使用2周的随访宽限期，72名患者（40.9%有完整的随访数据）在2周内完成了随访。在研究期结束时，229名患者（57.1%）失访。
对于被监禁或处于移民拘留状态的患者，护理延迟和就诊流失情况严重。需要开展更多工作来量化这些边缘化社区的护理结果并解决护理差异问题。
