Social Risk Factors Associated With Microbial Keratitis

Area of Science:

• Ophthalmology
• Public Health
• Health Services Research

Background:

• Microbial keratitis (MK) is a serious eye infection requiring timely and consistent care.
• Social risk factors (SRFs) can create significant barriers to accessing and adhering to healthcare.
• The Penchansky-Thomas (P-T) framework provides a model for understanding healthcare access dimensions.

Purpose of the Study:

• To identify social risk factors (SRFs) impacting microbial keratitis (MK) care.
• To analyze these SRFs using the Penchansky-Thomas (P-T) health care access framework.
• To explore the association between SRFs and patient outcomes, including loss to follow-up.

Main Methods:

• A combined retrospective and prospective cohort study of 100 newly diagnosed MK patients.
• Data collection via in-person interviews and chart reviews to identify SRFs.
• Categorization of SRFs into P-T framework domains and statistical analysis of demographic differences and impact on follow-up.

Main Results:

• 60% of MK patients reported at least one SRF affecting their care.
• Accessibility (49%) and distance to appointments (45%) were the most reported barriers.
• Patients with lower incomes reported more SRFs, and a higher prevalence of SRFs was associated with being lost to follow-up (100% vs. 52.4%).

Conclusions:

• Social risk factors, particularly related to accessibility and affordability, affect the majority of patients with microbial keratitis.
• Lower socioeconomic status is linked to a greater burden of SRFs.
• SRFs are a significant predictor of patients being lost to follow-up care, highlighting a critical gap in MK management.