Abstract：
Characterize clinical and socioeconomic factors that impact follow-up to complete retinal vascularization and subsequent pediatric ophthalmology follow-up in neonates with retinopathy of prematurity.
Medical records of 402 neonates diagnosed with retinopathy of prematurity from neonatal intensive care units at the University of California, Los Angeles Mattel Children\'s Hospital and the University of California, Los Angeles Santa Monica Hospital, both academic medical centers, and the Harbor-University of California, Los Angeles Medical Center, a safety-net county hospital, were reviewed. Primary study outcomes were the rate of follow-up to complete retinal vascularization and adequate pediatric ophthalmology follow-up. Secondary outcome was the rate of nonretinal ocular comorbidity.
In whole-cohort analysis, 93.6% of neonates were followed to complete retinal vascularization, and 53.5% had adequate pediatric ophthalmology follow-up. Public insurance was associated with lower rates of pediatric ophthalmology follow-up (Odds ratio 0.66, 95% confidence interval 0.45-0.98, P = 0.04). Participants screened at the academic medical center had lower rates of pediatric ophthalmology follow-up compared with the safety-net county hospital (50.7% vs. 63.5%, P = 0.034). In subgroup analysis, academic medical center participants with public insurance were less likely to have pediatric ophthalmology follow-up than safety-net county hospital participants with public insurance (36.5% vs. 63.8%, P < 0.001) or those with private insurance at the academic medical center (36.5% vs. 59.2%, P< 0.001).
This study identified high follow-up rates to complete retinal vascularization, lower pediatric ophthalmology follow-up rates, and nonretinal ocular comorbidity at all hospitals. Insurance status relative to hospital type was identified as a risk factor for loss to follow-up. This demonstrates a need to further study health care disparities in retinopathy of prematurity infants.
Medical records of 402 neonates diagnosed with retinopathy of prematurity from neonatal intensive care units at the University of California, Los Angeles Mattel Children\'s Hospital and the University of California, Los Angeles Santa Monica Hospital, both academic medical centers, and the Harbor-University of California, Los Angeles Medical Center, a safety-net county hospital, were reviewed. Primary study outcomes were the rate of follow-up to complete retinal vascularization and adequate pediatric ophthalmology follow-up. Secondary outcome was the rate of nonretinal ocular comorbidity.
In whole-cohort analysis, 93.6% of neonates were followed to complete retinal vascularization, and 53.5% had adequate pediatric ophthalmology follow-up. Public insurance was associated with lower rates of pediatric ophthalmology follow-up (Odds ratio 0.66, 95% confidence interval 0.45-0.98, P = 0.04). Participants screened at the academic medical center had lower rates of pediatric ophthalmology follow-up compared with the safety-net county hospital (50.7% vs. 63.5%, P = 0.034). In subgroup analysis, academic medical center participants with public insurance were less likely to have pediatric ophthalmology follow-up than safety-net county hospital participants with public insurance (36.5% vs. 63.8%, P < 0.001) or those with private insurance at the academic medical center (36.5% vs. 59.2%, P< 0.001).
This study identified high follow-up rates to complete retinal vascularization, lower pediatric ophthalmology follow-up rates, and nonretinal ocular comorbidity at all hospitals. Insurance status relative to hospital type was identified as a risk factor for loss to follow-up. This demonstrates a need to further study health care disparities in retinopathy of prematurity infants.
摘要：
目的：表征影响早产儿视网膜病变（ROP）新生儿完成视网膜血管化随访和后续儿科眼科随访的临床和社会经济因素。
方法：加州大学洛杉矶分校美泰儿童医院和加州大学洛杉矶分校圣莫尼卡医院的新生儿重症监护病房（NICU）诊断为ROP的402名新生儿的病历，这两个学术医疗中心(AMC)，加州大学洛杉矶分校港湾医疗中心,安全网县医院(SNCH)，被审查了。主要研究结果是完成视网膜血管化的随访率和足够的儿科眼科随访。次要结果是非视网膜眼合并症的发生率。
结果：在整个队列分析中，93.6％的新生儿完成了视网膜血管化，53.5％的新生儿进行了充分的儿科眼科随访。公共保险与较低的儿科眼科随访率相关（OR0.66，95％CI0.45-0.98，p=0.04）。与SNCH相比，在AMC筛查的参与者的儿科眼科随访率较低（50.7％vs.63.5%,p=0.034)。在亚组分析中，与有公共保险的SNCH参与者相比，有公共保险的AMC参与者进行儿科眼科随访的可能性较小（36.5％vs.63.8%,p<0.001)或在AMC拥有私人保险的人(36.5%与59.2%,p<0.001)。
结论：这项研究确定了完成视网膜血管化的高随访率，较低的儿科眼科随访率，所有医院都有非视网膜眼合并症。相对于医院类型的保险状况被确定为随访损失的风险因素。这表明需要进一步研究ROP婴儿的医疗保健差异。
方法：加州大学洛杉矶分校美泰儿童医院和加州大学洛杉矶分校圣莫尼卡医院的新生儿重症监护病房（NICU）诊断为ROP的402名新生儿的病历，这两个学术医疗中心(AMC)，加州大学洛杉矶分校港湾医疗中心,安全网县医院(SNCH)，被审查了。主要研究结果是完成视网膜血管化的随访率和足够的儿科眼科随访。次要结果是非视网膜眼合并症的发生率。
结果：在整个队列分析中，93.6％的新生儿完成了视网膜血管化，53.5％的新生儿进行了充分的儿科眼科随访。公共保险与较低的儿科眼科随访率相关（OR0.66，95％CI0.45-0.98，p=0.04）。与SNCH相比，在AMC筛查的参与者的儿科眼科随访率较低（50.7％vs.63.5%,p=0.034)。在亚组分析中，与有公共保险的SNCH参与者相比，有公共保险的AMC参与者进行儿科眼科随访的可能性较小（36.5％vs.63.8%,p<0.001)或在AMC拥有私人保险的人(36.5%与59.2%,p<0.001)。
结论：这项研究确定了完成视网膜血管化的高随访率，较低的儿科眼科随访率，所有医院都有非视网膜眼合并症。相对于医院类型的保险状况被确定为随访损失的风险因素。这表明需要进一步研究ROP婴儿的医疗保健差异。
