Abstract
Purpose :
During the COVID-19 pandemic, ophthalmology faced a regression of outpatient visits due to close-contact patient care and outpatient treatment emphasis. We conducted a retrospective, observational chart review to explore the impact that the pandemic had on ophthalmology outpatient visits by subspecialty at the UVM Medical Center. We hypothesized that patient volumes across different ophthalmology subspecialties fell in response to the pandemic spread.
Methods :
Patient care was studied using daily patient volumes, cancellations and no-show rates per ophthalmic subspecialty using data from the EMR system at UVMMC. Charts were reviewed for a year from the date that elective surgeries were restricted, March 23rd 2020 to March 22nd 2021, which was compared to the previous year to contrast pre-pandemic and pandemic outpatient volumes. Data manipulation and analysis was performed using Microsoft Excel and SPSS respectively. T-tests were performed with a p < 0.05. The different categories explored included the subspecialties of Neuro-Ophthalmology, Glaucoma, Cornea, Comprehensive, Retina, Pediatric and the demographic variables of Race (Non-White vs White), Sex (Male vs. Female) and Medicaid Status (Medicaid users vs. those with Commercial Insurance). Daily COVID-19 numbers were mapped from this time period to explore changes in appointment status with the progression of the pandemic.
Results :
The specialties that experienced the largest and smallest percentage drops in appointments were Comprehensive and Glaucoma respectively. During the highest COVID-19 impact months of March 2020 to June 2020, all subspecialties and demographics studied experienced a drop in appointments with Comprehensive and the Retina subspecialties experiencing the largest and smallest percentage drops at 80.5% and 35.9% respectively. There was no significant difference in appointment status in relation to race (white vs non-white) and sex (male vs female). Medicaid patients experienced a less severe drop in completed appointments at 15.5% vs. 24.4% in Non-Medicaid patients. There was also an observed increase in cancellations rates from March 2020 to July 2020 in all subspecialties.
Conclusions :
Our results are consistent with our hypothesis that the COVID-19 pandemic would lead to decreased patient volumes across ophthalmic subspecialties. We hope to utilize the study findings to explore the long-term health impacts from delayed care due to the COVID-19 pandemic.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.