Female Sex, Asian Race Associated with Health Care Utilization for Ocular Inflammatory Disease

At the American College of Rheumatology (ACR) Convergence 2021, researchers presented an analysis on trends in health care utilization for ocular inflammatory disease according to patient demographics.

“Health care utilization has an impact on disease progression and outcome in rheumatologic care.  Disparities based on race, sex, education, and income level affect care of our patients,” wrote the study authors. “Ocular inflammatory diseases increase disease burden in many rheumatologic conditions.”

For this study, the researchers queried Medicare data and the Intelligent Research in Sight (IRIS) registry to identify incidence of health care use for ocular inflammatory and infectious diseases in North America between 2016 and 2017. IRIS is a clinical registry from the American Academy of Ophthalmology. In 2018, IRIS collected data from more than 90% of ophthalmologists in the US.

Categories for inflammatory and infectious eye diseases, according to ICD-10 codes, include subgroups of ocular inflammatory conditions, lacrimal system and orbital inflammation, keratitis, conjunctivitis, eyelid inflammation and infection, and endophthalmitis.

The researchers reported that female sex was associated with higher health care utilization regardless of race in both Medicare and IRIS data. Among both males and females, Asian patients had higher utilization in both databases. Hispanic patients had the second highest rate of health care usage in the Medicare database for both years, regardless of sex. In the IRIS database, North American Native patients had the second highest utilization, also irrespective of sex.

When stratified by race and sex simultaneously, Asian females, followed by Asian males, had the highest utilization of care for ocular inflammation and infection, in both databases.

The authors summarized: “Females, Asians, Hispanics, and Native Americans having higher utilization for both the years 2016 and 2017. This may be due to higher disease prevalence or higher service utilization. Further studies are needed to clarify this and to help in making informed policy decisions.”