Abstract
Purpose :
The limited access to ophthalmologic care for minority populations in Texas’ US-Mexico border regions highlights a pervasive gap in healthcare, especially in the context of diabetic retinopathy (DR). To address this, our observational cross-sectional study compares the prevalence and severity of DR in Hispanic Medicare recipients across Texas border and non-border areas.
Methods :
County-level DR prevalence data was obtained from the Center for Disease Control and Prevention’s Vision and Eye Health Surveillance System (VEHSS) database of 2019 Medicare Fee-for-service claims. DR was subclassified by the VEHSS as vision-threatening stage (VTDR) and non-vision-threatening stage (NVTDR). VTDR includes severe non-proliferative DR, proliferative DR, or diabetic macular edema, while NVTDR includes mild or moderate non-proliferative DR without VTDR. Texas counties were split into border (N=32) or non-border (N=222) based on the Texas Department of State Health Services’ definition of a border county: any county within 100 kilometers from the southern Texas-Mexico border. DR prevalence for each region was computed using weighted county sample sizes. Statistical analyses employed two-sample independent t-tests, reporting prevalence rates, 95% Confidence Intervals (CI), and p-values.
Results :
Distinct variations in DR prevalence among Hispanic Medicare populations in Texas were observed. In border populations, Hispanic Medicare recipients showed a significantly higher prevalence of NVTDR (3.61%, CI=2.99-4.23%) when compared to non-border populations (2.90%, CI=2.77-3.02%; p=0.0143). VTDR also showed increased prevalence in Hispanic border populations (4.46%, CI=3.98-4.93%) compared to Hispanic non-border populations (3.91%, CI=3.79-4.04%; p=.0153). Overall, DR prevalence among Hispanic border populations (8.05%, CI=7.04-9.05%) was significantly greater than Hispanic non-border populations (6.79%, CI=6.60-6.99%; p=.0090).
Conclusions :
Our findings indicate significant disparities in the prevalence and severity of DR among Hispanics in Texas border counties. The pronounced prevalence in border regions underscores the need for targeted healthcare interventions, including enhanced DR screening and tailored patient education. Further investigations are recommended to identify the underlying socioeconomic and healthcare access factors contributing to these disparities.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.