Income Disparities in Outcomes of Horizontal Strabismus Surgery in a Pediatric Population

Alexandra N. Zdonczyk, Gaurang Gupte, Anna Schroeder, Varsha Sathappan, Andrew R. Lee, Susan M. Culican

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE: To examine postoperative outcomes in pediatric patients undergoing strabismus surgery to determine the potential impact of socioeconomic disparities on ophthalmic outcomes. METHODS: This study included 284 children undergoing strabismus surgery at a tertiary institution with at least 11 months of follow-up and no prior strabismus surgery or other neurologic or ophthalmologic conditions. Demographics, insurance, operative parameters, and appointments scheduled/attended were collected via chart review. Ocular alignment was recorded preoperatively and postoperatively at 3, 12, and 24 months. Two-sided t tests and chi-squared analyses were used to compare demographic and operative parameters. Logistic regression was employed to determine predictive factors for ophthalmic outcomes. RESULTS: There was no difference in failure rates between patients with Medicaid and patients with private insurance 24 months postoperatively (45.9% vs 50.5%, respectively, P = .46). Patients with Medicaid were more likely to not follow up postoperatively (28.2% vs 9.6%, respectively, P < .01), whereas patients with private insurance were more likely to complete more than three follow-up appointments in 24 months (21.5% vs 39.0%, respectively, P < .01). Postoperative attendance was linked to Medicaid status (P < .01) but not travel time, neighborhood income levels, or social deprivation index factors. CONCLUSIONS: There was no difference in failure rates between patients with Medicaid and patients with private insurance. Medicaid status was significantly predictive of loss to follow-up. [J Pediatr Ophthalmol Strabismus. 2022;59(3):156-163.].

Original languageEnglish
Pages (from-to)156-163
Number of pages8
JournalJournal of Pediatric Ophthalmology and Strabismus
Volume59
Issue number3
DOIs
StatePublished - May 1 2022

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