Healthcare Access and Utilization Among Glaucoma Patients in a Nationwide Cohort

Delavar, Arash Ghorbannia; Saseendrakumar, Bharanidharan Radha; Weinreb, Robert N.; Baxter, Sally L.

doi:10.1097/ijg.0000000000002123

Cited by 4 publications

(9 citation statements)

References 36 publications

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“…While prior studies have linked eye care access and glaucoma prevalence, this study specifically examines the relationship between eye care access and levels of glaucoma severity, as well as the likelihood of having incisional surgery. 5,6 A possible explanation for the association between access to eye care and increased likelihood of all levels of glaucoma severity is that patients with glaucoma must visit an eye care provider to receive a formal diagnosis. This is in line with a study by Ko et al, 10 which demonstrated that individuals with more health care utilization were more likely to be diagnosed with glaucoma.…”

Section: Discussionmentioning

confidence: 99%

“…This may be due to the fact that individuals with advanced stages of the disease require more procedures and eye care resources and have shorter recommended follow-up times due to the severity of their disease. 5,11 However, those with access to eye care also had increased odds of mild and moderate glaucoma compared with individuals without access to eye care. Our finding of a higher prevalence of any glaucoma in those with access to eye care suggests the possibility of missed glaucoma diagnoses in individuals who are unable to see an eye care provider.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, among individuals with glaucoma, those who had access to eye care had an increased likelihood of any incisional glaucoma surgery and of trabeculectomy but not of tube shunt. While prior studies have linked eye care access and glaucoma prevalence, this study specifically examines the relationship between eye care access and levels of glaucoma severity, as well as the likelihood of having incisional surgery 5,6 …”

Section: Discussionmentioning

confidence: 99%

“…In addition, while those with access to an eye care provider had higher adjusted odds of all levels of glaucoma severity, the highest adjusted odds were among those with a diagnosis of severe glaucoma. This may be due to the fact that individuals with advanced stages of the disease require more procedures and eye care resources and have shorter recommended follow-up times due to the severity of their disease 5,11 . However, those with access to eye care also had increased odds of mild and moderate glaucoma compared with individuals without access to eye care.…”

Section: Discussionmentioning

confidence: 99%

“…The high number of individuals with undiagnosed or untreated glaucoma raises concerns about vision monitoring and preventative treatment as a lack of disease monitoring and treatment can ultimately lead to an increased risk of blindness as a result of disease progression 2 . Compared with non-Hispanic white individuals, black, Asian, and Hispanic or Latino individuals have been shown to have a higher degree of glaucoma severity at the time of diagnosis 3–6 . Prior research has shown that these individuals also have greater odds of undergoing incisional glaucoma surgery, typically reserved for later stages of the disease 1,2 .…”

mentioning

confidence: 99%

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Access to Eye Care Providers and Glaucoma Severity in the National Institutes of Health All of Us Research Program

Paul,

Kitayama,

et al. 2023

Journal of Glaucoma

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Précis: In the “All of Us (AoU) Research Program,” individuals with access to vision care were more likely to have mild, moderate, or severe glaucoma and undergo incisional surgery compared with those without vision care access. Purpose: To examine the associations between access to eye care, glaucoma severity, and incisional glaucoma surgery using data from the National Institute of Health AoU Research Program. Materials and Methods: Individuals with International Classification of Diseases Ninth or 10th Revision codes and who answered the survey question about eye care access in AoU were included in the study. The exposure variable was access to eye care services, with outcome variables (1) glaucoma severitys and (2) likelihood of incisional surgery. Unadjusted multinomial logistic regression compared access to eye care services and glaucoma severity. In addition, unadjusted logistic regression models compared access to eye care and the likelihood of incisional surgery. These were repeated using adjusted analyses, controlling for sex assigned at birth, race and ethnicity, and age. Results: Compared with individuals without access to eye care services, those with access were more likely to have all levels of glaucoma severity [mild adjusted odds ratio (aOR): 5.81, 95% CI: 3.15–10.73, moderate aOR: 4.44, 95% CI: 2.45–8.02, severe aOR: 6.95, 95% CI: 2.69–17.93, and unspecified aOR: 3.06, 95% CI: 2.72, 3.45]. Access to eye care was associated with increased odds of any incisional glaucoma surgery (aOR: 3.00, 95% CI: 1.24–9.90) and of trabeculectomy (aOR: 3.30, 95% CI: 1.02–20.28) but not of tube shunt procedures (aOR: 2.65, 95% CI: 0.80–16.38). Conclusions: This study demonstrated that access to eye care services was associated with a higher prevalence of all levels of glaucoma severity; those with access to eye care services were more likely to undergo incisional surgery than those without access. Future research should focus on methods to best encourage eye care to limit glaucoma progression.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Access to Eye Care Providers and Glaucoma Severity in the National Institutes of Health All of Us Research Program

Paul,

Kitayama,

et al. 2023

Journal of Glaucoma

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Trends of Surgery, Patient, and Surgeon Characteristics for Corneal Transplants in the Medicare Population From 2011 to 2020

Webb,

Dun,

Dai

et al. 2024

Cornea

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Purpose: The aim of this study was to describe recent trends in corneal transplants and patient and surgeon characteristics for corneal transplants that occurred in the Medicare population. Methods: This was a retrospective, cross-sectional study using Current Procedural Terminology codes. We identified Medicare Fee-For-Service (FFS) claims for different types of corneal transplant procedures performed on Medicare beneficiaries aged 65 years or older from 2011 to 2020. Number and types of corneal transplants performed each year and patient and surgeon demographics and characteristics were analyzed. Results: We analyzed 148,981 corneal transplants performed by 2972 surgeons within the study period. Most corneal transplants performed were endothelial keratoplasties (70.1%). Most patients were women (60.3%) and White (85.8%). 18.2% of patients lived in a rural area, whereas only 3.5% of transplants occurred in a rural area and 5% of surgeons practiced in a rural area. Male surgeons represented 77.8% of all surgeons and performed 84.9% of all corneal transplants in the study period. The proportion of corneal transplants performed by female surgeons gradually increased over time, from 12.1% in 2011 to 19.0% in 2020. The proportion of female surgeons also increased from 16.2% in 2011 to 23.8% in 2020. Most surgeons (67%) performed <6 corneal transplants per year. Conclusions: Although the number of female corneal transplant surgeons has increased over time, women remain underrepresented in the surgical workforce. Further investigation should be conducted to identify the underlying reason and address the identified disparities within the landscape of corneal transplantation.

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Understanding racial disparities of glaucoma

Barquet-Pizá,

Siegfried

2023

Current Opinion in Ophthalmology

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Purpose of review Increased prevalence, earlier onset, and more rapid progression to vision loss from glaucoma has demonstrated racial disparity in numerous studies over decades. Precise etiologies of these important differences among patients of African and Hispanic ancestral background have not been elucidated. This review focuses on currently available epidemiologic/population, genetic, socioeconomic and physiologic studies of racial disparities in this blinding disease. Recent findings In depth reviews of several landmark studies of glaucoma prevalence in various racial groups have highlighted potential challenges of lack of recruitment of diverse populations in genetic studies and clinical trials, challenges of racial stratification of subjects, and the impact of socioeconomic variables. Summary Through a more comprehensive analysis of racial disparities of glaucoma, both clinicians and researchers may provide more effective population screening and management with a holistic approach for individualized patient care to provide improved outcomes. Future studies of interventions in sociodemographic factors and genetic/physiologic variables that influence the prevalence, access, and consequential vision loss from glaucoma will be crucial to minimize/eliminate racial disparities and improve outcomes for all.

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Healthcare Access and Utilization Among Glaucoma Patients in a Nationwide Cohort

Cited by 4 publications

References 36 publications

Access to Eye Care Providers and Glaucoma Severity in the National Institutes of Health All of Us Research Program

Access to Eye Care Providers and Glaucoma Severity in the National Institutes of Health All of Us Research Program

Trends of Surgery, Patient, and Surgeon Characteristics for Corneal Transplants in the Medicare Population From 2011 to 2020

Understanding racial disparities of glaucoma

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