The impact of demographic factors and insurance type on wait times for elective retina surgery

Identifying socioeconomic disparities in retina care may inform public health interventions and improve access to sight-restoring care. We sought to evaluate for the presence of disparities in wait times for elective retina surgery at an academic medical center and Veteran’s Affairs (VA) hospital using electronic health record (EHR) data from 435 adult patients. The following variables were extracted from the EHR: participants’ age, sex, race, marital status, and health insurance plan. Time to elective retina surgery (TTS) was calculated as the number of days between the documented decision to proceed with surgery and the surgery date. We assessed whether any of the variables were associated with significant differences in TTS via the Mann-Whitney U test or Kruskal-Wallis test. There were no differences in TTS between sexes, Black and White patients, or marital statuses (p = 0.431, 0.364, and 0.441, respectively). Commercial insurance holders and patients with Medicaid had shorter median TTS than patients with VA insurance (p = 0.016 and 0.019, respectively). Other factors historically linked to disparities in medical care were not associated with delays in elective retina surgery. We suggest that efforts designed to address socioeconomic and demographic disparities in ophthalmic care should be targeted at initial access to subspecialty eye care.