Disparities remain in access to ROP care
KOLOA, Hawaii — Socioeconomic factors have led to disparities in access to retinopathy of prematurity care, according to a speaker at Retina 2023.
Yoshihiro Yonekawa, MD, said a good classification system, screening guidelines and treatment options have meant that children born prematurely in the United States generally have good ROP outcomes overall.
“However, do all babies in our country have equal access to this vision-saving treatment?” Yonekawa said. “It’s a huge difference if you’re born in New York City, where you have a NICU every couple of blocks, or if you’re born in middle-of-nowhere Montana, where there are very few NICUs to have access to.”
Yonekawa and colleagues combined publicly available data sets and a database of NICUs that provide ROP care to calculate real-time driving distance to the nearest ROP treatment centers for census tracts all over the country. They were looking for communities that had to travel more than 60 minutes to the nearest treatment center.
For people living in an urban census tract, the average time to a level 3 or 4 NICU was 22.21 minutes. The average time for rural census tracts was 76.74 minutes. More than 60% of people in rural areas live more than an hour from a level 3 or 4 NICU. When looking at NICUs that offer any ROP treatment, the percentage rose to more than 80%.
People living in Lincoln County, Montana, had the longest travel time, more than 8 hours, to the nearest NICU.
Yonekawa said there were links between living in poverty and living in the West or South and lower access to care. Minority communities and communities with less education and lower insurance coverage were also at risk for poor ROP treatment.
“We have a lot of work that still needs to be done in this field,” Yonekawa said. “This provides good data to get the ball rolling.”
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Yonekawa Y. Access disparities to ROP treatment centers in the United States. Presented at: Retina 2023; Jan. 15-20, 2023; Koloa, Hawaii.
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