Abstract
Purpose :
There is a nationwide shortage of pediatric eye specialists. Inadequate or inaccessible subspecialty eye care may lead parents to bring their children to the emergency room (ER) to address eye problems which could have been handled at a clinic visit, if available. The goal of this study was to determine the association between childhood eye-related ER visits and the geographic location of pediatric eye specialists in California.
Methods :
Pediatric patients ≤18 years of age were identified using the California Office of Health Care Access and Information database for ER visits occurring between January 2012 and December 2021. International Classification of Diseases (ICD) diagnosis codes were used to identify eye-related ER visits. Public databases were used to identify pediatric ophthalmologists and optometrists. Census data was used to determine the number of visits per 10,000 children in each zip code. For incidence data, only zip codes with more than 500 children were included. A linear regression model was performed to assess the relationship between ER visits and provider density.
Results :
Of the 117,363,721 ER visits in California between 2012-2021, 27,346,729 (23.3%) were for children ≤18 years, of which 366,820 (1.3%) were eye-related. For eye-related visits, median age was 5.0 years (IQR = 2.0, 10.0) and 51.7% were male. The most common diagnoses were conjunctivitis (245,226; 66.9%), chalazion/blepharitis (54,865; 15.0%), and other disorders of the eye/adnexa (12,664; 3.5%). Mean number of visits per year per 10,000 children was 43.9±27.6 (median 38.2, IQR = 23.4, 58.2). For the 8,710,767 children ≤18 in California, the number of providers was 142 (1 per 61,413 children). The linear regression showed that zip codes with more providers had fewer ED visits: each additional provider per 10,000 children was associated with 2.1 fewer ED visits per 10,000 children (95%CI -0.04 to -4.25; P = 0.046; Figure 1).
Conclusions :
Overall, the most common causes of eye-related ER visits were for non-emergent eye conditions. There was a low eye provider to child ratio and an association between provider density and eye-related ER visit incidence. Expanding pediatric eye care could improve access and decrease ER utilization for non-emergent eye concerns.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.