Abstract:AIM: To determine the annual trends and risk factors for delayed access to care in community hospitals across Central Thailand—an area with high occupational injury risk. METHODS: This retrospective cross-sectional study analyzed data from four community hospitals in Central Thailand over six years (October 1, 2018–September 17, 2024). Patients aged ≥20y with ocular injuries, identified via International Classification of Diseases-10 (ICD-10) codes, were included. Demographics, injury characteristics, and care-seeking behaviors were recorded. Delayed access was defined as presentation >24h post-injury. Linear and logistic regression models were used to identify associated risk factors. Annual fiscal trends were analyzed to assess year-to-year patterns in delayed healthcare access. RESULTS: Among 6571 ocular injury cases, 4034 (61.4%) were male, with median age 43y [interquartile range (IQR) 31–57y], and 3983 (79.3%) were manual laborers. Delayed healthcare access was observed in 2426 cases (36.9%). Significant risk factors included age ≥60y [aOR: 1.55; 95% confidence interval (CI): 1.32–1.82], visits to F2-level hospitals [adjusted odds ratio (aOR): 2.03; 95%CI: 1.73–2.38], and outpatient visits (aOR: 14.01; 95%CI: 12.18–16.12). In F2 hospitals, subgroup analysis revealed a U-shaped reduction in delayed healthcare access for ocular injuries during the COVID-19 pandemic (2019–2021), adjusted for age and gender. CONCLUSION: This first in-depth study of ocular injuries in Central Thailand’s community hospitals found persistently high delayed presentations, with older age, F2 hospital visits, and outpatient department (OPD) attendance as key contributing factors. The trend during the COVID-19 pandemic highlights the important role of lower-tier community hospitals in providing prompt and accessible care for patients. Strengthening healthcare infrastructure and public awareness is essential to ensure timely care and reduce preventable vision-related complications.
