Nationwide Demographic Disparities in United States Emergency Department Visits in Patients With Rhegmatogenous Retinal Detachment

Abstract

Background/Purpose: Within the evolving landscape of healthcare in the United States (US), delineating the demographic nuances and financial implications of emergent conditions, such as rhegmatogenous retinal detachment (RRD), is paramount. This study seeks to analyze the demographic and hospital billing amount/cost of service disparities in RRD visits to emergency departments (EDs) nationwide. Methods: We conducted a retrospective, cross-sectional, population-based study using International Classification of Diseases, 10th revision, and Current Procedural Terminology codes in the 2016 to 2019 Nationwide Emergency Department Sample databases to identify RRD visits. The analysis included demographics, hospital billing amount, and cost of service of RRD ED management. Results: A total of 12,492 RRD encounters were identified with men constituting 64% and a prominent age group being 50 to 64 years (49.3%). Most patients (90%) were managed in metropolitan teaching hospitals, predominantly in the southern U.S. region (56.1%). Private insurance covered 45% of patients. Same-day RRD repair odds increased in November and December. Whites had a higher likelihood for same-day treatment. Hospital billing amount rose from $23,600 in 2016 to $30,354 in 2019, with stable mean total cost of service. Rhegmatogenous retinal detachment ED visit incidence did not show seasonal variation (P = 0.819). Conclusion: Most patients with RRD in U.S, EDs were middle-aged men, with Whites more likely to receive same-day repair. There was no sex bias observed in same-day repair decision-making. Although hospital billing amount increased over the study period, total cost of service remained stable. The incidence of RRD ED visits showed no seasonal variation.

Implications of Neighborhood- and Patient-Level Factors for Eye Care

“…1.75-8.47; P = .001). 2 Many EDs do not have retina surgeons on staff or on call, and so many people then need to be referred to a retina surgeon after their visit to the ED. However, it has been reported that a quarter of patients presenting to the ED with an ophthalmic condition are lost to follow-up, with a higher rate of loss to follow-up among patients that have Medicaid or are uninsured compared with those with commercial insurance.…”