Abstract
Purpose :
To examine the association of demographic factors with the use of remote retinal screening in 2019 California Medicare beneficiaries diagnosed with Type II Diabetes (DM II).
Methods :
The study population included all Medicare beneficiaries with claims for DM II diagnosis among those ≥65 years old with at least one part-B claim in California in 2019. The diagnosis of DM II was based on International Classification of Diseases 10th Revision, Clinical Modification (ICD-10-CM) diagnosis codes (E11). Demographic factors included age (65-69, 70-74, 75-79, 80-84, 85+), sex (male, female), and race and ethnicity (Non-Hispanic White, Black, Asian, Hispanic, Other). The outcome of interest was remote retinal imaging, which was defined as retinal imaging with remote clinical staff review as identified through claims for Current Procedural Terminology (CPT) codes (92227). Multivariable logistic regression modeling was performed to examine the association between demographic predictors and use of remote retinal screening, adjusting for all other demographic factors and the presence of hypertension.
Results :
There were 768,544 Californian Medicare patients with DM II, of whom 737 (0.10%) underwent remote retinal imaging. Compared with patients age 65-69, older patients were less likely to receive remote retinal imaging: 70-74 (adjusted odds ratio [aOR]=0.67,[0.56,0.80]), 75-79 (aOR=0.45,[0.36,0.57]), 80-84 (aOR=0.42,[0.32,0.54]), 85+ (aOR=0.25,[0.18,0.35]). Compared with Non-Hispanic White patients with DM II, Black (aOR=3.82,[3.05,4.79]), Hispanic (aOR=1.93,[1.61,2.31]), and Other (aOR=1.71,[1.24,2.36]) patients were more likely to receive remote retinal imaging, while Asian patients did not have a statistically significant difference in the odds of remote retinal imaging (aOR=1.08,[0.85,1.37]). Compared with male DM II patients, females (aOR=1.03,[0.89,1.19]) did not have a statistically significant difference in the odds of remote retinal imaging.
Conclusions :
Among California Medicare patients with DM II in 2019, younger patients and those from Black, Hispanic, and Other racial and ethnic backgrounds were more likely to receive remote retinal imaging compared to older and Non-Hispanic White patients, respectively. Further investigation is needed to assess whether these differences represent disparities in the ophthalmic care of diabetic patients in California.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.