Abstract
Purpose :
The 2019 coronavirus pandemic reshaped how pediatricians triage referrals. This study aimed to assess the quality of pediatric ophthalmology referrals before and after the pandemic.
Methods :
Retrospective chart review of new pediatric ophthalmology referrals across the same three months per year between 2019-2021. Referral quality was graded on a scale of 0-2 (0=low, 1=moderate, 2=high) with 1 point awarded for each of the following: pediatrician-performed in-person ocular examination, telemedicine ocular examination, continued ophthalmic care recommended after ophthalmology evaluation. A multinomial regression was performed assessing referral quality and demographic changes.
Results :
609 of 1181 referrals reviewed were included (572 excluded, mostly due to duplicate or incomplete referrals). Referral quality was similar over time (2019: 1.57; 2020: 1.58; 2021: 1.55, all p>0.05). Female-identifying patients had lower odds of receiving high quality referrals (OR=0.04, p=0.008). No difference was observed between referrals for self-reported Asian and White patients. The remaining patients were categorized as “All Other Races”, and had lower odds of receiving moderate quality referrals as White patients (OR=0.10, p=0.043). Referrals for prematurity (OR=0.03) were found to have lower odds of receiving high quality referrals, while those for trauma (OR=6.24) had greater odds of receiving high quality referrals (all p<0.001). Between 2020-2021, compared to an in-person evaluation, referrals based on telemedicine had lower odds of requiring continued ophthalmic care (OR=2.39, p=0.015).
Conclusions :
While referral quality across the years was similar, non-White and non-Asian patients were more likely to have lower quality referrals. Referrals based on telemedicine evaluation were less likely to warrant continued ophthalmic care.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.