June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Associations between healthcare utilization and access and diabetic retinopathy complications
Alison Chan; John McDermott; Terrence Lee; Gordon Ye; Bita Shahrvini; Bharanidharan Radha Saseendrakumar; Sally Liu Baxter
Author Affiliations & Notes
  • Alison Chan
    Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, United States
    Department of Biomedical Informatics, University of California San Diego, La Jolla, California, United States
  • John McDermott
    Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, United States
    Department of Biomedical Informatics, University of California San Diego, La Jolla, California, United States
  • Terrence Lee
    Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, United States
    Department of Biomedical Informatics, University of California San Diego, La Jolla, California, United States
  • Gordon Ye
    Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, United States
    Department of Biomedical Informatics, University of California San Diego, La Jolla, California, United States
  • Bita Shahrvini
    Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, United States
    Department of Biomedical Informatics, University of California San Diego, La Jolla, California, United States
  • Bharanidharan Radha Saseendrakumar
    Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, United States
    Department of Biomedical Informatics, University of California San Diego, La Jolla, California, United States
  • Sally Liu Baxter
    Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California, United States
    Department of Biomedical Informatics, University of California San Diego, La Jolla, California, United States
  • Footnotes
    Commercial Relationships   Alison Chan, None; John McDermott, None; Terrence Lee, None; Gordon Ye, None; Bita Shahrvini, None; Bharanidharan Radha Saseendrakumar, None; Sally Baxter, None
  • Footnotes
    Support  National Institutes of Health (grant DP5OD029610) and an unrestricted departmental grant from Research to Prevent Blindness.
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 1124. doi:
  • Views
  • Share
  • Tools
    • Alerts
      User Alerts
      You are adding an alert for:
      Associations between healthcare utilization and access and diabetic retinopathy complications
      You will receive an email whenever this article is corrected, updated, or cited in the literature. You can manage this and all other alerts in My Account
      The alert will be sent to:
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation
      Citation

      Alison Chan, John McDermott, Terrence Lee, Gordon Ye, Bita Shahrvini, Bharanidharan Radha Saseendrakumar, Sally Liu Baxter; Associations between healthcare utilization and access and diabetic retinopathy complications. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1124.

      Download citation file:

      © ARVO (1962-2015); The Authors (2016-present)

      ×
    • Get Permissions
  • Supplements
Abstract

Purpose : To assess whether variations in healthcare utilization and access are associated with increased risk of developing proliferative diabetic retinopathy (PDR) or related complications.

Methods : We identified 1,882 adult participants in the NIH All of Us Research Program data repository with diabetic retinopathy (DR) based on diagnostic billing codes. Electronic health record data regarding comorbidities, laboratory values, and procedures were extracted. Healthcare utilization and access were assessed using participant responses to surveys on frequency of medical care, ability to afford care, and reasons for delaying medical care. Multivariable logistic regression with bi-directional stepwise variable selection was performed from a wide range of predictors to assess whether social determinants were associated with increased risk of developing PDR or related complications (e.g. neovascular glaucoma). Statistical significance was defined as p<0.05.

Results : The mean (standard deviation) age of 1882 adults with DR enrolled in All of Us was 63.7 (11.0) years. The majority (57.3%) were female. 36.9% identified as Hispanic or Latino. 13.1% of DR patients had not spoken to an eye doctor in the past 12 months, and 10-20% of patients endorsed several reasons for avoiding or delaying care, including financial concerns and transportation (Figure 1). The number of eye doctor visits (odds ratio [OR] 1.46, 95% confidence interval [CI] 1.07-1.99, p=0.02) and diabetic kidney disease (OR 3.88, 95% CI 1.37-11.07, p=0.01) were associated with increased odds of developing PDR and related complications. Significant social determinants included healthcare coverage not accepted by provider (OR 3.48, 95% CI 1.35-12.10, p=0.02) and inability to afford general healthcare provider (OR 8.42, 95% CI 1.12-74.3, p=0.04) (Table 1).

Conclusions : Understanding the social determinants that influence risk for developing complications can help inform population health interventions. Nationwide data with diverse enrollment demonstrate that some DR patients face substantial barriers to healthcare access.

This is a 2021 ARVO Annual Meeting abstract.

 

Figure 1. Distribution of diabetic retinopathy patient responses to healthcare utilization and access surveys.
View OriginalDownload Slide

Figure 1. Distribution of diabetic retinopathy patient responses to healthcare utilization and access surveys.

Figure 1. Distribution of diabetic retinopathy patient responses to healthcare utilization and access surveys.

Figure 1. Distribution of diabetic retinopathy patient responses to healthcare utilization and access surveys.
View OriginalDownload Slide
 
Table 1. Multivariable logistic regression model predicting the development of proliferative diabetic retinopathy or related complications in adult patients with diabetic retinopathy.
View OriginalDownload Slide

Table 1. Multivariable logistic regression model predicting the development of proliferative diabetic retinopathy or related complications in adult patients with diabetic retinopathy.

Table 1. Multivariable logistic regression model predicting the development of proliferative diabetic retinopathy or related complications in adult patients with diabetic retinopathy.

Table 1. Multivariable logistic regression model predicting the development of proliferative diabetic retinopathy or related complications in adult patients with diabetic retinopathy.
View OriginalDownload Slide

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Attribution-NonCommercial-NoDerivatives
Copyright © 2025 Association for Research in Vision and Ophthalmology.
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×
This site uses cookies. By continuing to use our website, you are agreeing to our privacy policy.Accept