Predictors of access to pediatric eye care appointments

Abstract

Purpose: To investigate predictors of access to pediatric eye care appointments in the United States.

Methods: A comprehensive list of pediatric ophthalmologists and optometrists was compiled, and offices were contacted to respond to a structured telephone survey regarding private insurance and Medicaid acceptance and appointment availability. Simple logistic regressions were used to assess risk factors affecting proportions of successful appointments and appointment wait times. Multivariable analysis adjusted for potential confounding factors, including physician type, practice type, geographic location, insurance type, and race majority in county. The main outcome measures were percentages of successful appointments, predictors associated with higher chances for a successful appointment, and average appointment wait times.

Results: A total of 925 offices of 1,528 providers were contacted (62% ophthalmologists). The percentage of successful appointments was significantly lower with ophthalmologists (39.7%) than optometrists (65.6% [P < 0.001]). Average wait times for successful appointments were significantly shorter at the offices of optometrists (25.4 ± 36.5 days) versus ophthalmologists (52.8 ± 58.3 days [P < 0.001]). Medicaid patients had a statistically significantly lower appointment success rate (37.2%) compared with the privately insured (62.0% [P < 0.001]), and their average wait times were 46.5 ± 56.19 days, compared with 40.0 ± 50.7 days for privately insured patients (P < 0.093). In majority White counties, appointments booked 50.2% (95% CI, 48.4-52.0) compared with 41.3% (95% CI, 34.6-48.0) in predominantly minority counties (P = 0.014).

Conclusions: Disparities in the proportions of booked appointments and wait times for pediatric eye care visits based on insurance type, provider type, and demographics underscore the need for increased access to pediatric eye care.