Diehl Thomas H, Malek Davina A, Cavuoto Kara M
University of Miami Miller School of Medicine, Miami, Florida.
Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
J AAPOS. 2025 Sep 18:104639. doi: 10.1016/j.jaapos.2025.104639.
To investigate predictors of access to pediatric eye care appointments in the United States.
A comprehensive list of pediatric ophthalmologists and optometrists was compiled, and offices were contacted to respond to a structured telephone survey regarding private insurance and Medicaid acceptance and appointment availability. Simple logistic regressions were used to assess risk factors affecting proportions of successful appointments and appointment wait times. Multivariable analysis adjusted for potential confounding factors, including physician type, practice type, geographic location, insurance type, and race majority in county. The main outcome measures were percentages of successful appointments, predictors associated with higher chances for a successful appointment, and average appointment wait times.
A total of 925 offices of 1,528 providers were contacted (62% ophthalmologists). The percentage of successful appointments was significantly lower with ophthalmologists (39.7%) than optometrists (65.6% [P < 0.001]). Average wait times for successful appointments were significantly shorter at the offices of optometrists (25.4 ± 36.5 days) versus ophthalmologists (52.8 ± 58.3 days [P < 0.001]). Medicaid patients had a statistically significantly lower appointment success rate (37.2%) compared with the privately insured (62.0% [P < 0.001]), and their average wait times were 46.5 ± 56.19 days, compared with 40.0 ± 50.7 days for privately insured patients (P < 0.093). In majority White counties, appointments booked 50.2% (95% CI, 48.4-52.0) compared with 41.3% (95% CI, 34.6-48.0) in predominantly minority counties (P = 0.014).
Disparities in the proportions of booked appointments and wait times for pediatric eye care visits based on insurance type, provider type, and demographics underscore the need for increased access to pediatric eye care.
调查美国儿童眼科护理预约的影响因素。
编制了一份全面的儿科眼科医生和验光师名单，并联系各诊所，以回应关于接受私人保险和医疗补助以及预约可用性的结构化电话调查。使用简单逻辑回归来评估影响成功预约比例和预约等待时间的风险因素。多变量分析对潜在混杂因素进行了调整，这些因素包括医生类型、诊所类型、地理位置、保险类型以及所在县的种族多数情况。主要结局指标为成功预约的百分比、与成功预约几率较高相关的预测因素以及平均预约等待时间。
共联系了1528名提供者的925家诊所（62%为眼科医生）。眼科医生的成功预约百分比（39.7%）显著低于验光师（65.6% [P < 0.001]）。验光师诊所成功预约的平均等待时间（25.4 ± 36.5天）明显短于眼科医生诊所（52.8 ± 58.3天 [P < 0.001]）。与私人保险患者相比，医疗补助患者的预约成功率在统计学上显著较低（37.2%）（私人保险患者为62.0% [P < 0.001]），他们的平均等待时间为46.5 ± 56.19天，而私人保险患者为40.0 ± 50.7天（P < 0.093）。在白人占多数的县，预约成功率为50.2%（95% CI，48.4 - 52.0），而在少数族裔占主导的县为41.3%（95% CI，34.6 - 48.0）（P = 0.014）。
基于保险类型、提供者类型和人口统计学特征，儿童眼科护理就诊的预约比例和等待时间存在差异，这突出了增加儿童眼科护理可及性的必要性。
