Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2025
Geographic and socioeconomic disparities to retinopathy of prematurity treatment.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Soares Rebecca R, Cai Louis, Samuelson Annika, Bowe Theodore, Huang Charles, Beca Flavius A, Hinkle John, Patel Samir N, Musch David, Vartanian Rebecca J, Vander James F, Ho Allen C, Spirn Marc, Klufas Michael A, Xu David, Besirli Cagri G, Yonekawa Yoshihiro
Аннотация
PURPOSE: To identify geographic and socioeconomic factors predictive of travel burden on families to neonatal intensive care units (NICUs) that provide acute treatment for retinopathy of prematurity (ROP) and long-term, outpatient follow up care.
DESIGN: This is a retrospective cross-sectional study.
METHODS: This cross-sectional analysis crosslinked data from a nationwide survey of NICU ROP treatment, with multiple large publicly available datasets. Geographic information systems analysis identified travel time from each census tract to the nearest NICU offering ROP treatment. Multivariable analysis identified socioeconomic predictors of driving time.
RESULTS: Rural residents had to travel significantly longer to reach an ROP treatment center compared to urban residents (103.23 ± 55.47 vs. 42.68 ± 41.40 min, p < 0.0001). Residents were more likely to travel > 60 min if they lived in rural census tracts (adjusted odds ratio [aOR] 1.33, 95% confidence interval [1.29-1.37], p < 0.0001) or lived in the West (aOR 1.11 [1.09-1.12], p < 0.0001) and South (aOR 1.19 [1.18-1.20], p < 0.0001), compared to the Northeast. Census tracts with a greater proportion living ≤ federal poverty level or with a greater proportion of non-whites also had increased travel burdens. In contrast, counties with higher percentages of births < 1500 g (aOR 0.90 [0.90-0.90], p < 0.0001) were less likely to travel > 60 min.
CONCLUSIONS: There are significant geographic access disparities to ROP treatment centers in the United States.
DESIGN: This is a retrospective cross-sectional study.
METHODS: This cross-sectional analysis crosslinked data from a nationwide survey of NICU ROP treatment, with multiple large publicly available datasets. Geographic information systems analysis identified travel time from each census tract to the nearest NICU offering ROP treatment. Multivariable analysis identified socioeconomic predictors of driving time.
RESULTS: Rural residents had to travel significantly longer to reach an ROP treatment center compared to urban residents (103.23 ± 55.47 vs. 42.68 ± 41.40 min, p < 0.0001). Residents were more likely to travel > 60 min if they lived in rural census tracts (adjusted odds ratio [aOR] 1.33, 95% confidence interval [1.29-1.37], p < 0.0001) or lived in the West (aOR 1.11 [1.09-1.12], p < 0.0001) and South (aOR 1.19 [1.18-1.20], p < 0.0001), compared to the Northeast. Census tracts with a greater proportion living ≤ federal poverty level or with a greater proportion of non-whites also had increased travel burdens. In contrast, counties with higher percentages of births < 1500 g (aOR 0.90 [0.90-0.90], p < 0.0001) were less likely to travel > 60 min.
CONCLUSIONS: There are significant geographic access disparities to ROP treatment centers in the United States.