Impact of socioeconomic factors in access to care in pediatric ophthalmology during the COVID-19 pandemic

Abstract

Introduction: Since the COVID-19 pandemic necessitated the widespread implementation of virtual visits, early evidence has suggested that vulnerable populations may be disadvantaged by these healthcare disruptions. We hypothesize that vulnerable populations have disproportionately lost access to care in pediatric ophthalmology during the pandemic. Methods: We examined patient demographics for visits in the pediatric ophthalmology department from 3/18/19-5/31/19 (pre-COVID period) and from 3/16/20 to 5/31/20 (COVID period). We used Pearson’s χ2 tests to compare proportions of overall and telehealth visits by our demographics of interest, with statistical significance set at P < 0.05. Results: During the pre-COVID period, 9793 visits occurred with 0.3% (27/9793) of visits conducted virtually. In the COVID period, 4240 visits occurred with 69.3% (2939/4240) of visits conducted virtually. Interpreters were listed as needed at 9.6% (945/9793) of pre-COVID period visits, compared to 7.1% (299/4240) of COVID period visits (P < 0.001). Patient language was reported as non-English at 11.6% (1132/9793) of pre-COVID period visits, compared to 8.2% (346/4240) of COVID period visits (P < 0.001). Patients who self-identified as non-White made up 25.2% (2464/9793) of pre-COVID period visits and 19.4% (824/4240) of COVID period visits (P < 0.001). Among virtual visits, utilization was lower than expected only among non-English speakers (P < 0.001). Conclusion/Relevance: Non-White patients, non-English speakers, and those requiring interpreters made up fewer overall visits during the COVID-19 pandemic, but virtual visit utilization was lower only among non-English speakers.