Impact of socioeconomic status on follow-up for pediatric closed-globe ocular injuries: a Massachusetts-based study

Main Article Content

Jonah Blumenthal, BS
Christopher Marshall, MPH
Blanche Kuo, BS
Melissa Yuan, MD
Mikhayla Armstrong, BA
Jennifer Welcher, MBA
Ankoor S. Shah, MD, PhD

Abstract

Introduction
This study aimed to determine whether there are differences in access to care across populations after a pediatric closed-globe ocular injury (CGI). It has been shown in other patient populations that lower socioeconomic status (SES) is associated with poorer health outcomes.(1,2) Currently, limited research exists on how SES affects outcomes and follow-up for pediatric CGI patients.
Methods
We conducted a retrospective cohort study using Boston Children’s Hospital’s enterprise data warehouse. Patients were identified using ICD-9/10 codes corresponding to CGI presenting to our hospital between 2002 to 2020. SES was determined using Area Deprivation Index.(3) We roughly divided our population into the top 50% and bottom 50% based on SES. A chi-squared test and binary logistic regression analysis evaluated the association between SES group and follow-up visit occurrence.
Results
The study included 1,329 pediatric patients with CGI. The population skewed towards higher SES; therefore, the data was stratified at the 4th decile of SES. Of the 1,329 patients, 619 were in the top SES group, and 710 were in the bottom group. overall, 1,051 followed-up, and 278 did not. The number of patients with follow-up was higher for the top SES group (86.5%) compared to the bottom SES group (74.9%). The χ² test demonstrated a significant association between SES group and follow-up. (χ² = 15.889; df = 1; P < 0.001). A logistic regression analysis showed a significant association between SES group and follow-up, with an odds ratio of 1.465 (95% CI, 1.058-2.025; P = 0.021), whereas including covariates like race, zone of injury, need for interpreter, and sex.
Conclusions
Our study highlights that lower SES in CGI patients is associated with a reduced chance of follow-up. These findings emphasize a need for further research, specifically aimed at parsing out contributing factors to lack of patient follow-up.

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How to Cite
1.
Blumenthal J, Marshall C, Kuo B, Yuan M, Armstrong M, Welcher J, Shah AS. Impact of socioeconomic status on follow-up for pediatric closed-globe ocular injuries: a Massachusetts-based study . Digit J Ophthalmol. 2024;30. Accessed July 21, 2024. https://djo.harvard.edu/index.php/djo/article/view/1108
Section
Abstracts

References

Kousiouris P, Klavdianou O, Douglas KAA, et al. Role of socioeconomic status (SES) in globe injuries: a review. Clin Ophthalmol 2022;16:25-31.

Social vulnerability index (SVI) and poor postoperative outcomes in children undergoing surgery in California (2022, September 27). Social Vulnerability Index (SVI) and poor postoperative outcomes in children undergoing surgery in California. ScienceDirect https://doi.org/10.1016/j.amjsurg.2022.09.030.

https://www.neighborhoodatlas.medicine.wisc.edu/.