Study Identifies Factors That Influence Retinal Surgery Cancellation

Researchers assessed demographic and medical factors that impact the likelihood of patients canceling retinal surgery and found that socioeconomic status, race, and diabetes were significant factors. The results of the study were published as part of the American Society of Retina Specialists 2020 Virtual Annual Meeting.

This retrospective study analyzed 3,306 consecutive cases of scheduled surgeries from a multi-provider, multi-location retina practice during a 10-month period. Cancellation was defined as a surgery that had been scheduled with the surgical center and was not performed.

Researchers used the American Community Survey 2017 database to assess patients’ home address zip codes and associated median household income. Patients were classified as:

  • Low income: less than $50,000 median income
  • Middle income: $50,000 to $75,000 median income
  • High income: greater than $100,000 median income

Researchers compared a cohort of 200 cancelled surgeries, as well as a cohort of 400 surgeries that went on as planned. Patients self-reported gender and race. Acuity of surgery and diabetes status were identified via a chart review.

A total of 199 surgeries were cancelled, for a cancellation rate of 5.99%. Among patients residing in low-income zip codes, the rate of cancellation increased to 10.15%, while it decreased to 3.98% among patients residing in high-income zip codes.

The relative risk of cancellation was 2.55 greater in the low-income group compared with the high-income group (P<0.0001). The following factors were significantly associated with surgery cancellation:

  • Diabetes (odds ratio [OR], 2.89; P<0.0001)
  • Identifying as non-white (OR, 2.33; P<0.0001)
  • Residing in zip codes with incomes lower than U.S. median (OR, 1.20; P=0.004)
  • Requiring surgery deemed non-acute (OR, 3.13; P=0.039)

Gender and age less than 65 years did not significantly impact the risk of surgery cancellation.

“Identification of these factors provides insight into disparities in access to care, enumerating barriers to care faced by our patients,” the researchers concluded.

Patel LG, Ho AC, Starr M, et al. Factors associated with risk of retinal surgery cancellation. Presented during the ASRS 2020 Virtual Annual Meeting, July 24-26, 2020.