710 - Factors Impacting Parental Compliance with Referral to Eye Care Provider after Instrument-Based Vision Screening in Preschool-Aged Children: Location, Location, Location
Friday, April 25, 2025
5:30pm – 7:45pm HST
Publication Number: 710.5007
E Eugenie Hartmann, Akron children's Hospital, Akron, OH, United States; Megan Woodward, Akron Children's Hospital, Alliance, OH, United States; Ian Boydstun, Akron Children's Hospital, Stow, OH, United States
Senior Research Scientist Akron children's Hospital Akron, Ohio, United States
Background: The purpose of vision screenings at Well Child Checks (WCCs) is to detect sight-threatening disorders that, unless treated, may lead to long-term visual impairment affecting the individual’s quality of life educationally, emotionally, and socially. We have previously demonstrated significant improvement in our rate of screening at 3-, 4- and 5-year WCCs with the use of a photoscreener. However, compliance with referrals, while essential, does not always occur. Objective: The purpose of this analysis is to examine factors impacting compliance with the recommendation of a Comprehensive Eye Examination (CEE) after vision screening in our preschool age group. Design/Methods: We tracked results of the screenings (pass versus refer) as well as whether the patient received a CEE at one of ACH’s Vision Centers following a referral. Through the end of 2022, a total of 4,190 patients were referred from the screenings. From this group, 3,126 complied with the referral, yielding a follow-up rate of 75%. We calculated both the Crude and the Adjusted Odds Ratio (COR and AOR) for the following three variables to determine the likelihood of a patient completing a CEE after being referred as a result of the instrument-based screening: 1) Childhood Opportunity Index (COI) for the patient based on zipcode. 2) Location of the Primary Care Pediatrics clinic also had a Vision Center clinic. 3) Age group of the patient. COI followed the accepted definition of Very Low, Low, Medium, High and Very High. Baseline for COI was fixed at Medium. Location of the Pediatric Clinic with a Vision Center was a binary variable: Yes or No. Age group of the child was set as 3-, 4- or 5-year-old and baseline was fixed at 3-year-old. Results: Both the crude and adjusted Odds Ratio are shown in Table 1. Considering the variable of age group, there was no difference in the likelihood of compliance with the referral based on age for either COR or AOR. For the COI variable, the likelihood of compliance with a referral was higher for the Very Low and the High groups when considering the AOR. When the Primary Care Clinic location also had a Vision Center clinic, the likelihood of compliance with the referral was 2.5 times higher than when there was no Vision Clinic at the location.
Conclusion(s): The strongest relationship between receiving a referral and compliance with that referral was the presence of a Vision Center clinic at the same location as the Primary Care office. Evidently, parental familiarity with an office location, increases the likelihood of compliance with a referral. Awareness of this association offers possibilities for improvement.
