advertisement
Abstract #60087 Published in IGR 16-4
The impact of lack of government-insured routine eye examinations on the incidence of self-reported glaucoma, cataracts, and vision loss
Chan CH; Trope GE; Badley EM; Buys YM; Jin YPInvestigative Ophthalmology and Visual Science 2014; 55: 8544-8549
PURPOSE: We determined the impact of lack of government insured routine eye examinations on the incidence of self-reported glaucoma, cataracts and vision loss. METHODS: We analyzed data from the Canadian longitudinal National Population Health Survey (1994-2011). White respondents aged 65+ in 1994/1995 were included (n = 2618). Three cohorts were established at baseline: those free of glaucoma, cataracts, and vision loss (i.e., unable to see close or distance when wearing glasses or contact lenses). Incident cases were identified through self-reporting of these conditions during the follow-up period. RESULTS: The incidence (per 1000 person-years) of glaucoma was lower in uninsured provinces (8.1; 95% confidence interval [CI], 5.5-10.7) than in insured provinces (12.8; 95% CI, 10.5-15.1). The incidence of cataracts was also lower in the uninsured (67.2; 95% CI, 55.7-78.6) versus insured provinces (75.7; 95% CI, 69.2-82.2). The incidence of vision loss was higher in the uninsured (26.6; 95% CI, 20.2-33.0) versus insured provinces (22.5; 95% CI, 20.0-25.5). Adjusting for confounders, seniors in insured provinces had a 59% increased risk of glaucoma (incidence rate ratio [IRR], 1.59; 95% CI, 1.07-2.37), a 13% greater risk of cataracts (IRR, 1.13; 95% CI, 0.93-1.37), and a 12% reduced risk of vision loss (IRR, 0.88; 95% CI, 0.67-1.16). CONCLUSIONS: Lack of government-funded routine eye examinations is associated with a reduced incidence of self-reported glaucoma and cataracts, likely due to reduced detection. Lack of insurance also is associated with a higher incidence of self-reported vision loss, likely due to poorer access to eye care and late treatment.
Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada.
Full articleClassification:
1.6 Prevention and screening (Part of: 1 General aspects)
14 Costing studies; pharmacoeconomics
