The Relative Impact of Patient, Physician, and Geographic Factors on Variation in Primary Rhegmatogenous Retinal Detachment Management

Vail, Daniel; Pershing, Suzann; Reeves, Mary-Grace R.; Afshar, Armin R.

doi:10.1016/j.ophtha.2019.04.019

Cited by 31 publications

(19 citation statements)

References 30 publications

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“…It has been reported in the USA that there are differences in the quality of medical care by region which is understandable considering the differences in the health insurance systems, regional socio-industrial structures, and racial composition 24 – 26 . In fact, the contribution of the provider level and regional level to the selection of treatment for RD has been shown for the United States 5 . Japan is a relatively small island nation with a homogeneous population, standardized medical education, and universal public health insurance.…”

Section: Discussionmentioning

confidence: 99%

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Regional and sex differences in retinal detachment surgery: Japan-retinal detachment registry report

Funatsu

Terasaki

Sakamoto

2021

Sci Rep

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It is known that social factors affect the choice of treatments, and special attention has been paid to sex differences. The purpose of this study was to determine whether regional and sex differences exist in the treatment of rhegmatogenous retinal detachment (RD). We used Japan-RD Registry database of 2523 patients aged ≥ 40 years between February 2016 and March 2017 in 5 Japanese regions. Regional differences of patients’ perioperative factors were analyzed. The factors affecting the proportion of patients who underwent surgery within one week of the onset, defined as early-surgery, were examined by logistic regression. We observed regional differences in perioperative factors, especially in the use of phacovitrectomy, general anesthesia, and air-tamponade, which was higher in certain regions. (Fisher’s exact test, all P = 0.012) The proportion of early-surgery was significantly higher among men in Kyushu region (Odds ratio (OR) 1.83; 95% confidence interval (CI) 1.08–3.12; P = 0.02), and it was also significantly higher after adjusting for covariates (OR 1.89; 95% CI 1.06–3.42; P = 0.02). Regional and sex differences exist in the treatment of RD in Japan. Although there was no significant differences in the anatomical outcomes, women in certain regions of Japan are less likely to receive early surgical intervention for RD.

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Section: Discussionmentioning

confidence: 99%

“…It was recently reported in the USA that the ratio of patients who underwent surgery for rhegmatogenous retinal detachment (RD) was lower in women 4 , 5 , 21 . The waiting period for cataract surgery in Sweden was also longer for women than men, and a sex gap was suggested 22 .…”

Section: Introductionmentioning

confidence: 99%

Regional and sex differences in retinal detachment surgery: Japan-retinal detachment registry report

Funatsu

Terasaki

Sakamoto

2021

Sci Rep

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“…Geographical variations least affected the management approach. 15 In 2012 US Medicare survey showed that 74%, 11% and 15% of primary RRD were repaired by PPV, SB and PR respectively. 16 The preferences and trends (PAT) survey of 2015 showed that 67% of the vitreoretinal surgeons placed SB in 11% of RRDs, while 24% placed SB in 41% RRDs.…”

Section: Discussionmentioning

confidence: 99%

Preferences and Trends in Management of Rhegmatogenous Retinal Detachment in Pakistan

Awan

Muid

2020

pak J Ophthalmol

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Purpose: To report the preferences and trends in managing Rhegmatogenous retinal detachment (RRD) in Pakistan. Study Design: Cross sectional survey. Place and Duration of Study: Shifa International Hospital, Islamabad, from December 2018 to January 2019. Method: A survey was conducted in which the vitreo-retinal (VR) surgeons were asked to respond to 10 questions. The questions were meant to assess their practice and management strategies in treating RRD. Duration of survey was 1 month. Results: Sixty-two VR surgeons of Pakistan responded to this survey. Most of the VR surgeons belonged to Punjab (56%) followed by Sindh (25%). Regarding their primary practice setting 50% of VR surgeons worked both in government and private practice, 30% practiced in academic/university hospital and 20% of them had only private practice. Seventy percent of VR surgeons in Pakistan preferred local anaesthesia. In non-posterior vitreous detachment (PVD) RRD, majority (69%) performed segmental buckling (SB) with or without encirclement. In pseudophakic superior macula on RRD with a single retinal tear 50% preferred pars plana vitrectomy (PPV) followed by SB in 25% and pneumatic retinopexy in 18%. In inferior macula off RRD with a retinal tear at 7 0’clock position, 56% of the VR surgeon performed PPV alone or combined with SB. Conclusion: There is an increased trend towards PPV as a primary procedure for RRD in Pakistani VR surgeons. Local anaesthesia is the preferred anesthesia. Key Words: Rhegmatogenous retinal detachment, Retinal break, Pars Plana Vitrectomy, Pneumatic Retinopexy.

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“…This database has been used extensively in the health care literature and has been used in prior studies of RRD surgery. 15,36 We included patients with an incident diagnosis of RRD who underwent repair with cryotherapy, laser photocoagulation, PR, SB, or PPV within 14 days of their first RRD diagnosis…”

Section: Data Source and Sample Selectionmentioning

confidence: 99%

Association of Rhegmatogenous Retinal Detachment and Outcomes With the Day of the Week That Patients Undergo a Repair or Receive a Diagnosis

et al. 2020

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IMPORTANCE Because variation in care on weekends has been reported in many surgical fields, it is of interest if variations were noted for care patterns of rhegmatogenous retinal detachments (RRDs). OBJECTIVE To assess the association between modality of RRD repair and day of the week that patients receive a diagnosis or undergo RRD repair. DESIGN, SETTING, AND PARTICIPANTS A retrospective claims-based cohort analysis was performed of primary RRD surgery for 38 144 commercially insured patients in the United States who received a diagnosis of incident RRD between January 1, 2008, and December 31, 2016, and underwent repair within 14 days of diagnosis. Multinomial regression models were used to assess patients' likelihood of repair with different modalities, logistic regression models were used to assess patients' likelihood of reoperation, and linear regression models were used to assess time from diagnosis to repair. Data analysis was performed from March 9 to September 5, 2019. EXPOSURES Day of the week that the patient received a diagnosis of RRD or underwent RRD repair. MAIN OUTCOME AND MEASURES Modality of repair, time from diagnosis to repair, and 30-day reoperation rate. RESULTS Among the 38 144 patients in the study (23 031 men [60.4%]; mean [SD] age at diagnosis, 56.8 [13.4] years), pneumatic retinopexy (PR) was more likely to occur when patients received a diagnosis of RRD on Friday (relative risk ratio [

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The Relative Impact of Patient, Physician, and Geographic Factors on Variation in Primary Rhegmatogenous Retinal Detachment Management

Cited by 31 publications

References 30 publications

Regional and sex differences in retinal detachment surgery: Japan-retinal detachment registry report

Regional and sex differences in retinal detachment surgery: Japan-retinal detachment registry report

Preferences and Trends in Management of Rhegmatogenous Retinal Detachment in Pakistan

Association of Rhegmatogenous Retinal Detachment and Outcomes With the Day of the Week That Patients Undergo a Repair or Receive a Diagnosis

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