PURPOSE To investigate relationships between health and socio-economic status with delayed attendance at routine eye examinations and risk of subsequent general practitioner (GP) referral in Northern Ireland. METHODS We constructed a cohort of 132 046 community dwelling individuals aged ≥60 years, drawing contextual information from the 2011 Northern Ireland Census. Using linked administrative records of routine eye examinations between 2009 and 2014, we calculated 311 999 examination intervals. Multinomial models were used to estimate associations between contextual factors and examination interval (classified into three groups: early recall, on-time, delayed attendance). Associations between examination interval and referral risk were estimated using logistic regression. RESULTS Delayed attendance was recorded for 129 857 (41.6%) examination intervals, 53 759 (17.2%) delayed by ≥6 months. Female sex, poor general or mental health were each associated with delay, as were longer distances to optometry services among those aged ≥70 years (longest vs shortest: Relative Risk Ratio = 1.21 [1.14, 1.28]). Low income and residence in social housing were associated with reduced delay risk. There were 3347 (3.5%) and 11 401 (5.3%) GP referrals in the 60-69 and ≥70 years age groups respectively. Delayed attendance was associated with increased referral risk in both groups (Odds Ratios: 60-69 years = 1.30 [1.04, 1.61]; ≥70 years = 1.07 [1.01, 1.13]). CONCLUSIONS Poor health and longer distances to optometry services were associated with delayed attendance at routine eye examinations but low income was not. Delayed attendance was associated with increased GP referral risk, indicative of missed opportunities to detect potentially serious eye conditions.

中文翻译：

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延迟参加常规眼科检查与全科医生转诊的可能性增加相关：北爱尔兰的一项记录关联研究。

目的调查在北爱尔兰，健康和社会经济状况与常规眼科检查延迟就诊以及随后转诊全科医生（GP）的风险之间的关系。方法我们根据2011年北爱尔兰人口普查的背景信息，构建了一个132 046个年龄≥60岁的社区居民的队列。使用2009年至2014年例行眼睛检查的相关行政记录，我们计算出311 999次检查间隔。多项式模型用于估计上下文因素与检查间隔之间的关联（分为三类：早期召回，准时，出勤延迟）。检验间隔和转诊风险之间的关联使用逻辑回归进行估计。结果记录了129 857（41。6％）的检查间隔，延迟了≥6个月的53759（17.2％）。女性，总体健康状况或心理健康状况差均与延误有关，≥70岁年龄段的患者验光服务距离也更长（最长vs最短：相对风险比= 1.21 [1.14，1.28]）。低收入和在社会住房中居住与减少延迟风险有关。60-69岁和70岁以上年龄组分别有3347（3.5％）和11 401（5.3％）的GP转诊。两组中推迟就诊与转诊风险增加相关（赔率：60-69岁= 1.30 [1.04，1.61]；≥70岁= 1.07 [1.01，1.13]）。结论健康状况差和验光距离较远与常规眼科检查迟到有关，而低收入却没有。出勤延迟与全科医生转诊风险增加有关，