학술논문
Socioeconomic Disparities and Emergency Department Visits for Diabetic Retinopathy in California.
Document Type
Academic Journal
Author
Akinyemi OA; The Clive O. Callender, M.D., Howard-Harvard Health Sciences Outcomes Research Center, Department of Surgery, Howard University College of Medicine, Washington, DC, USA.; Jones Md LS; Department of Ophthalmology, Howard University College of Medicine, Washington, DC, USA.; Ochoa A 3rd; Department of Ophthalmology, Howard University College of Medicine, Washington, DC, USA.; Nelson L; Howard University College of Medicine, Washington, DC, USA.; Weldeslase TA; The Clive O. Callender, M.D., Howard-Harvard Health Sciences Outcomes Research Center, Department of Surgery, Howard University College of Medicine, Washington, DC, USA.; Yousuf SJ; Department of Ophthalmology, Howard University College of Medicine, Washington, DC, USA.
Source
Publisher: Sage Publications Country of Publication: United States NLM ID: 101700301 Publication Model: eCollection Cited Medium: Internet ISSN: 2474-1272 (Electronic) Linking ISSN: 24741264 NLM ISO Abbreviation: J Vitreoretin Dis Subsets: PubMed not MEDLINE
Subject
Language
English
Abstract
Purpose: To investigate the association between neighborhood-level socioeconomic factors, quantified by the Distressed Communities Index, and emergency department visits for diabetic retinopathy (DR). Methods: All patients who presented to the emergency department for DR in California were analyzed using the State Emergency Department Database (2018-2020). Patients were stratified by Distressed Communities Index score and DR severity. Logistic regression was applied to explore the independent correlation between Distressed Communities Index scores and proliferative DR (PDR). Results: Of 2 725 195 emergency department visits for diabetic patients, Distressed Communities Index data were available for 2 459 577 (90.3%); 39 693 were for DR, including 13 617 (34.3%) for PDR. Hispanics (44.2%) were the largest racial/ethnic group to present for PDR, followed by non-Hispanic Whites (19.6%) and non-Hispanic Blacks (19.3%). A significant association was observed between the Distressed Communities Index and emergency department visits for PDR, with distressed neighborhoods having the highest incidence (adjusted odds ratio [aOR], 1.63; 95% CI, 1.20-2.23; P = .001). Other predictors included Hispanic ethnicity (aOR, 2.21; 95% CI, 1.97-2.48; P < .001) and Black race (aOR, 1.46; 95% CI, 1.28-1.67; P < .001) compared with White race and having Medicaid (aOR, 1.37; 95% CI, 1.13-1.65; P = .001) compared with private insurance. Conclusions: The Distressed Communities Index identified patients residing in the most distressed neighborhoods as being at the highest risk for presenting to the emergency department for PDR based on 7 socioeconomic factors. Policymakers may consider the Distressed Communities Index as a tool for targeting DR prevention strategies and improving healthcare accessibility.
Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
(© The Author(s) 2024.)
Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
(© The Author(s) 2024.)