Diabetes retinopathy screening: audit of equity in participation and selected outcomes in South East London.
OBJECTIVE
To assess uptake of the diabetes retinopathy screening programme in South East London and examine variation in attendance and screening outcomes.


METHODS
Cross-sectional study of patients on a centralized disease register invited for retinal screening during 2003. The influence of age, gender, deprivation, region of birth and type of diabetes on screening attendance and outcomes was assessed.


RESULTS
An estimated 46% of residents with known diabetes (9750/21,104) were offered digital retinopathy screening during 2003. In all, 88.9% of patients who were invited for screening attended. Attendance rates were significantly lower in younger patients (< or = 40 years), in those with type 1 diabetes and in patients residing in areas with the highest levels of deprivation. A total of 28.9% of patients had background retinopathy or worse during 2003. Retinopathy was more common in older patients (>40 years) and in individuals with type 1 diabetes after adjusting for other factors. Patients born outside the United Kingdom and the Republic of Ireland were significantly more likely to present with retinopathy.


CONCLUSIONS
This study identified considerable inequity in the delivery of a local diabetic retinopathy screening programme. Equity audits should form an integral component of ongoing quality assurance monitoring of retinopathy screening programmes.
Millett
Christopher
C
Department of Primary Care & Social Medicine, Imperial College Faculty of Medicine, London W6 8RP, UK. c.millett@imperial.ac.uk
Dodhia
Hiten
H
D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D003922:Diabetes Mellitus, Type 1; D003924:Diabetes Mellitus, Type 2; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D011785:Quality Assurance, Health Care; D012737:Sex Factors