This study aimed to identify clinical and social determinants of health (SDOH) factors associated with adherence to the recommended follow-up care interval for infants screened for retinopathy of prematurity (ROP). This was a retrospective cohort study from 2018–2022 of 723 patients (49% male, 40% Black, 53% White, 2% Asian, 4% Hispanic and 0.4% unknown). Median maternal age was 29 years and median gestational age at birth was 29 weeks. Highest ROP stage was 0 (59%), stage 1–2 (29%) and ≥stage 3 (12%). Retinopathy of prematurity treatment was required for 12%. Length of stay in neonatal ICU was 13 weeks on average. Follow-up appointments were attended by 42% from 8 weeks to 1 year post discharge with median time to follow-up of 28 weeks. Public/combined public-private insurance was held by 67%, private by 33% and uninsured/self-paying by 0.3%. Associations with greater odds of attending follow-up appointments included distance to home, private insurance, White ethnicity, history of ROP treatment and longer NICU stay – x30 greater odds of attendance. Of concern was the disproportionate increase in ROP incidence among patients from communities with lower access to follow-up care and therefore, these children are at most risk. Social determinants of health significantly impact access to ROP follow-up.
Social determinants of health associated with rates of attendance for ROP follow-up
Reviewed by Fiona Rowe
Social determinants of health affecting retinopathy of prematurity follow-up attendance.
CONTRIBUTOR
Fiona Rowe (Prof)
Institute of Population Health, University of Liverpool, UK.
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