Purpose

The purpose was to assess differences in outpatient ophthalmologic usage based on patient characteristics such as race/ethnicity, income, insurance type, geographical region, and educational attainment.

Design

Retrospective cross-sectional study.

Methods

The Medical Expenditure Panel Survey (MEPS) is a nationally representative data set for the noninstitutionalized population cosponsored by the Agency for Healthcare Research. This study involved 183,054 MEPS respondents from 2007 to 2015. Primary outcome measure was patient utilization of outpatient ophthalmologic care. Secondary outcome measure was annual health care use and costs by patients in outpatient, inpatient, and the emergency department settings based on race.

Results

Overall, 21,673 participants self-reported an ophthalmologic condition, and 12,462 had at least 1 outpatient ophthalmologic visit. Hispanic (adjusted odds ratio [aOR] 0.72; P < .001) and black patients (aOR 0.74; P < .001) had fewer outpatient visits than their non-Hispanic white counterparts. Uninsured (aOR 0.41; P = .009) and Medicare/Medicaid (aOR 0.92; P < .001) patients had less outpatient care than their privately insured counterparts. Increasing income and education was associated with higher outpatient ophthalmologic care utilization. In the emergency department, non-Hispanic white patients had the least encounters (1.1 per 100 patients) and highest costs ($25,314.05) when compared to non-Hispanic black patients (3.2 encounters per 100 patients and $10,780.22 respectively) and Hispanic patients (2.2 encounters per 100 patients and $9,837.03 respectively).

Conclusions

This study's findings demonstrate differences in outpatient ophthalmologic utilization based on demographic and socioeconomic characteristics. Concurrently, minority Americans had more ophthalmic emergency department visits but lower cost per visit. There is a need to further characterize these differences to predict future ophthalmologic care needs.

中文翻译：

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美国门诊眼科使用率的人口统计学和社会经济差异。

目的

目的是根据患者特征（如种族/种族，收入，保险类型，地理区域和教育程度）评估门诊眼科使用情况的差异。

设计

回顾性横断面研究。

方法

医疗支出小组调查（MEPS）是由国家医疗保健研究机构（NASA）赞助的非机构化人口的全国代表性数据集。这项研究从2007年到2015年涉及183,054名MEPS受访者。主要结局指标是患者对门诊眼科护理的利用。次要结局指标是年度医疗保健使用情况以及门诊，住院患者和急诊科根据种族划分的患者费用。

结果

总体而言，有21673名参与者自我报告了眼科疾病，并且12462名参与者至少进行了1次门诊就诊。西班牙裔美国人（调整后的优势比[aOR]为0.72；P <.001）和黑人患者（aOR 0.74；P <.001）的门诊次数少于非西班牙裔白人。未投保（aOR 0.41; P  = 0.009 ）和Medicare / Medicaid（aOR 0.92; P<.001）的患者的门诊治疗要少于私人保险的患者。收入和教育程度的提高与门诊眼科护理利用率的提高有关。在急诊科，与非西班牙裔黑人患者（分别为每100名患者3.2次和每例10,780.22美元）和西班牙裔患者（共2.2次）相比，非西班牙裔白人患者的遭遇最少（每100名患者1.1次），费用最高（25,314.05美元）。每100名患者和$ 9,837.03）。

结论

这项研究的结果表明，根据人口统计和社会经济特征，门诊眼科手术的利用率存在差异。同时，少数美国人的眼科急诊就诊次数更多，但每次诊治成本较低。需要进一步表征这些差异，以预测未来的眼科护理需求。