The primary aim of this study was to compare postoperative outcomes in a larger cohort of paediatric patients having strabismus surgery with at least 11 months follow-up to determine the impact of low socio-economic status (SES) and health disparities and evaluate the impact of neighbourhood socio-economic characteristics on outcomes. This was a retrospective review of patient records for those having horizontal strabismus surgery. One thousand four hundred and fifty-three records were identified and 284 met the inclusion criteria. Ninety-eight patients received Medicaid and 186 had private insurance. There were similar deviation angles: 25.3 versus 25.4PD at distance and 28.4 versus 27.2PD at near, respectively for Medicaid versus private insurance. Groups were also similar for presence / absence of amblyopia, eso versus exo deviations and failure rates (45.9% versus 50.5%). Patients with Medicaid were more likely to have no follow-up appointments (28.2% vs 9.6% with insurance) or to schedule a follow-up appointment (15.8% versus 5.9%). They were more likely to have a lower median household income and high measures of social deprivation. Single-parent family scores were the only significant predictor of surgical success but this was not clinically significant. Limitations of this study included that this was retrospective, had unequal group distribution, limited follow-up period, and lack of control of treatment adherence. Overall, outcomes were similar regardless of insurance. However there was an association for loss to follow-up with Medicaid status.
Outcomes for strabismus surgery dependent on access to insurance
Reviewed by Fiona Rowe
Income disparities in outcomes of horizontal strabismus surgery in a pediatric population.
CONTRIBUTOR
Fiona Rowe (Prof)
Institute of Population Health, University of Liverpool, UK.
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