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Jennifer Oluyemisi Adeghate, Alexander Port, Nicole Papworth-Jones, Grace Sun; Who should we be screening for eye disease? The impact of demographic and socioeconomic background on attendance and referral patterns at an integrated vision screening program.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5079.
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Community-based screening seeks to identify those with vision-threatening conditions; however, many severe cases still remain undetected. Our study aims to determine how socio-demographic factors may influence screening outcomes in an integrated setting.
We conducted a retrospective review of patients screened through the Kress Vision Program over a two-year period (January 1st, 2014 - December 31st, 2015) at New York-Presbyterian/Lower Manhattan Hospital. Demographic data (age, gender, ethnicity, ZIP code) and screening outcomes (follow-up versus procedure) were recorded. ZIP codes were used to determine average commute-time from the screening center using Google Maps™, as well as poverty level, income and level of education based on publicly available data from the US Census Bureau. Statistical analysis was performed using SPSS.
Of 1,311 screened patients, 392 required further evaluation, and 58 patients underwent surgery or had an intravitreal injection (75 eyes). Most patients screened were age 26-64 (n=914, 69.7%), followed by 0-25 (n=263, 21.1%) and 65+ (n=134, 10.2%). More women (n=764, 58.3%) than men were screened, but more men than women were referred (34.0% and 27.0%, respectively; p=0.007). Excluding those of unknown ethnicity, most un-referred patients were Hispanic women (33.9%; p=0.027), while most referred were African American men (32.3%; p=0.06). Lower poverty rates (22.9%; p<0.103), higher median income ($51,548/year; p<0.015), and higher levels of education (78.2%; p<0.001) were seen in those referred versus those un-referred (23.9%, $48,300/year, 76.0%, respectively). Average commute-time from the 49 most common ZIP codes was 52 minutes (n=830). 64 of these patients commuted 0-30 minutes, 217 commuted 31-44 minutes, and 549 commuted 45+ minutes to reach the screening center.
Our results indicate that the population most likely in need of eye care are working-age men and women of Hispanic and African American ethnicity. These groups may lack sufficient access to eye care providers, and may benefit more from targeted screenings. Socioeconomic factors did have an effect on referral patterns, though differently than expected; however, longer commute-time did not seem to have an impact on the incentive to seek free medical care.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
Socio-demographics of screened patients.
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