Abstract
Purpose :
Prior research has demonstrated that in cities with unequal spatial distribution of resources and healthcare access, residents living in under-resourced city regions have higher rates of chronic disease, disease severity, and / or increased disease mortality. Service Planning Areas (SPAs) are geographic regions organized by census tracts and zip codes in Los Angeles county for planning, statistical tracking, providing health and social services. The purpose of this study was to examine the association between SPAs and the prevalence of chronic eye disease in Los Angeles (LA) County.
Methods :
The study population included all 2019 California Medicare beneficiaries in LA county. The prevalence of glaucoma, age-related macular degeneration, diabetic retinopathy and cataracts was assessed by International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) diagnosis codes. Zip codes from all 2019 beneficiaries were collected and organized into their corresponding SPA. We calculated both overall and individual prevalence of chronic eye diseases in all eight SPAs. Associations between SPA and prevalence of eye disease was assessed using logistic regression models, adjusting for age, gender, race, and the Charlson Comorbidity Index (CCI) score.
Results :
Among 809,562 California Medicare beneficiaries in LA county, 114,234 (14.11%) had any eye disease, including 53,387 (6.59%) beneficiaries with glaucoma, 24,929 (3.01%) with macular degeneration, 14,697 (1.82%) with diabetic retinopathy, and 75,742 (9.36%) with cataract. SPA 3 had the highest number of Medicare beneficiaries (n = 197,875) and SPA 5 had the lowest number (n = 4,928). Compared to residents in SPA 3, residents in SPA 5 had significantly increased odds of having any eye disease (adjusted odds ratio [aOR] = 1.55; 95% confidence interval [CI] = 1.43-1.67; p < .001), whereas residents in SPA 1 had lower odds of having any eye disease (aOR = 0.64; 95% CI, 0.60-0.68; p < .001).
Conclusions :
In 2019 California Medicare beneficiaries in LA county, there were statistically significant differences in the prevalence of chronic eye disease by SPAs, indicating a possible relationship between residential location, healthcare access and ocular health outcomes.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.