Abstract
Purpose :
Acute angle-closure glaucoma (AACG) is an ophthalmic emergency caused by buildup of intraocular pressure. AACG requires prompt treatment to prevent permanent optic nerve damage. We retrospectively analyzed the incidence of AACG in Texas to determine whether cost and treatment choice varied across, race, ethnicity, or region.
Methods :
Anonymous records from the Texas outpatient public use data file (PUDF) were searched for all incidence of AACG between January 1, 2016 and December 31, 2018. Data collected included age, race, ethnicity, sex, medical insurance status, procedures implemented, treatment cost, region, and source of admission. Data were analyzed to determine whether either a) cost of treatment, or b) rate of surgical intervention for AACG (including iridotomy, iridectomy, trabeculoplasty, shunt placement, corneal incision) varied demographically or by region.
Results :
1,349 cases of AACG were documented in Texas between 2016 and 2018. Hispanic patients received proportionally fewer surgical interventions for AACG than non-Hispanic patients (P<0.001). Surgical interventions also varied among races, with Asian/Pacific Islanders receiving proportionally more surgical treatment and African Americans receiving less treatment (P<0.001). Patients with private/self-pay health insurance received proportionally more surgical interventions for AACG as compared to patients with other forms of coverage. (P<0.001).
Hispanic patients were charged significantly more ($709.50) than non-Hispanics for their AACG treatment (P<0.01), and were simultaneously less likely than non-Hispanics to receive a surgical intervention for AACG (P<0.001). Costs also differed significantly by race, with Asian/Pacific islanders paying higher costs than other groups (P<0.001).
Conclusions :
Treatment costs and surgical interventions vary significantly by race, ethnicity, and insurance status. Some findings, such as higher disease burden among Asian Americans, may be adequately explained by known difference in disease demographic by race. However, instance of lower rates of surgical intervention in combination with higher average cost among Hispanic Americans further investigation, and may represent instances of inequity in the delivery of healthcare in Texas.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.