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Iridocyclitis in a Nationally-Representative Database: Demographics and their Impact on Patient Care
Rayna Marshall
Presenter:
Rayna Marshall, Meghan Berkenstock, MD
Authors:
Affiliation:
1. Drexel University College of Medicine, Philadelphia, PA
2. Johns Hopkins Medicine Wilmer Eye Institute, Baltimore, MD
Purpose: Cases of chronic iridocyclitis can necessitate long term treatment with corticosteroid eye drops resulting in recurrent follow-up appointments, increased time spent with physicians, and financial cost. Analyzing the demographic distribution and patient factors influencing treatment and time spent with physicians in this population using the National Ambulatory Medical Care survey (NAMCS) has not previously been studied.
Methods: Data was extracted from the NAMCS database, a large, nationally-representative survey of primary care physicians and a sample of visits to health centers, entered between 2012-2016 and 2018. Patients with iridocyclitis were retrospectively analyzed by using all other patients in the database as the control group. Demographic information collected included sex, race, ethnicity, number of chronic conditions, major reason for visit, type of payment for visit, corticosteroid eye drops prescriptions, and time spent with the physician. Chi square, logistical regression, and dichotomized variable T-tests were used for statistical analyses.
Results: Overall 129,641 patients were included of which 188 had a diagnosis of iridocyclitis. Patients with iridocyclitis were more likely to be non-Caucasian (p=0.0001) and more likely to be visiting the physician’s office due to flare of or treatment for a chronic medical problem (p<0.0001). Adjusted for age, sex, race, and ethnicity, iridocyclitis patients spent a significantly longer time (avg. 26.11 minutes) compared to other patients (avg. 23.53 minutes) with their physician (p=0.0318). Among the iridocyclitis patient population, African American patients (p=0.03), privately-insured patients (p=0.005), and patients visiting for a new problem (p=0.01) or post-surgery (p=0.01) all spent significantly more time with a physician.
Conclusion: Our results show a significant demographic difference with a higher proportion of non-Caucasian iridocyclitis patients, and average time spent with a physician was 2.5 minutes longer at office visits. Among iridocyclitis patients, African American, privately-insured, and post-op patients spent more time with a physician than other respective races, payer type, or reason for office visit. Providers should be aware of the additional support and time needed by these patients during office visits.