[Predictors of the appropriateness of first presentation in an university ophthalmology outpatient clinic: an analysis of sociodemographic factors].

backgroundThe increasing shortage of specialists in ophthalmology and the rising burden on university eye clinics raise questions about the appropriateness of the utilization of university resources. This study investigates the relationship between various sociodemographic determinants, such as age or social status, and the appropriateness of first presentation in a university ophthalmology outpatient clinic.

methodsA retrospective analysis was conducted using routine data from 182,170 patients of the university outpatient clinic at the University Medical Center Freiburg (2006-2023). The appropriateness of the first presentation was operationalized by a follow-up visit within 100 days. Social status was assessed using the social index of the City of Freiburg at the postal code level. The data analysis considered relevant covariates such as age, gender, type of consultation, insurance status, distance from residence, and the social index of Freiburg.

resultsOf the included patient visits, 42.7% were classified as appropriate. An older age (odds ratio (OR) 1.36 per standard deviation (SD), 95% confidence interval (CI): 1.34-1.37) was the strongest predictor of the appropriateness of the presentation. The social index showed a weaker but significant effect (OR 1.05 per SD, 95% CI: 1.02-1.07): a lower social status was associated with increased appropriateness. The distance from residence had no significant influence.

conclusionThe results indicate an association between increased urgency of care and both higher patient age and lower social status, with the latter potentially reflecting care gaps or delayed utilization. The study provides important insights for needs-based resource planning and health policy measures aimed at optimizing ophthalmological care structures.