Social vulnerability and reliability to attend clinic appointments in an urban oculoplastic surgery clinic

The social vulnerability index (SVI) is a community-level scoring system based on US Census tract, designed to assess vulnerability during disasters. Here, we evaluate the relationship of CDC-defined SVI with office visit compliance in an urban oculoplastic surgery clinic.

In this single-center retrospective study, age, gender, race/ethnicity, electronic accessibility status, residential address, and number of completed and no-show visits were collected of individuals treated at an oculoplastic clinic from Sept 2020 to Sept 2023. The 2020 Census Tract SVI scores were obtained using the residential addresses for the overall SVI, four thematic SVIs, and 16 social factors' SVIs. A greater SVI (range 0-1) indicates higher social vulnerability. Categorical, numerical, and logistic regression statistical tests were performed to determine factors predictive of unreliable visit attendance, defined as failure to attend >25% of scheduled appointments.

The final analysis included 3,287 patients with a mean age of 52 ± 21 years, 61% of whom were female. In the study period, 787 patients (24%) were found to have unreliable attendance at their scheduled appointments. Having an overall SVI of 0.75 or higher was associated with an increased likelihood of unreliable visit attendance (OR 2.7, 95% CI 2.1-3.5, p < 0.001). Additionally, a thematic SVI of 0.75 or higher regarding racial and ethnic minority status resulted in an increased likelihood of unreliable attendance (OR 2.1, 95% CI 1.2-3.4, p = 0.008).

This is the first study showing that living in communities with high SVI scores is associated with poor oculoplastic surgery office visit attendance.