Impact of Area of Deprivation Index on Ophthalmology Consultation in the Emergency Department

Purpose: To evaluate if individual sociodemographic and Area of Deprivation Index (ADI) are associated with receiving an Ophthalmology consultation when self-presenting to the Emergency Departments (EDs) with an eye-related chief complaint. Methods: Retrospective review of patients presenting to Harborview Medical Center and University of Washington Medical Center EDs between 2/2022 and 1/2023. Individual sociodemographic were obtained from medical records; ADI was calculated based on the patient's home address. Encounters were categorized as emergent, nonemergent, or could not be determined based on final diagnosis. Chi-Square and ttest were used for categorical and continuous variables, respectively. Odds ratios (OR) and confidence intervals (CI) were calculated using binomial logistic regression. Results: 1,212 patients were included; 36.1% were 18-39, 44.2% were 40-64 and 19.6% were ≥65 years old. The median and interquartile range of ADI scores was 14.0 and 17.0 respectively. Although overall ADI scores were similar for patients who received (47.3%) or did not receive a consultation (56.7%) (17.3 ± 14.1 vs. 16.7 ± 13.9, p=0.419), patients with emergent diagnoses who received a consultation had higher ADI scores (more disadvantage) (19.1 ± 15.9 vs. 15.3 ± 13.7, p=0.018). Younger age group (OR 1.83; CI 1.27-2.63) and nonemergent diagnosis (OR 3.82; CI 2.72-5.36) were associated with higher odds of not receiving a consultation (p≤0.001). Conclusions: Among patients with a final diagnosis in the emergent category, those with higher ADI scores were more likely to be seen by Ophthalmology, while patients in the age 18 to 39 years old group had higher odds of not receiving a consultation.