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Yaping Jin, Richard Wedge, Sherif El-Defrawy, John G Flanagan, Yvonne M Buys, Graham Eric Trope; Lack of government-funded optometric services is associated with reduced utilization of eye care providers and increased utilization of family doctors. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1379.
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© ARVO (1962-2015); The Authors (2016-present)
Canadian optometric eye care services are inconsistently funded by provincial governments. We investigated whether lack of provincial government-insured optometric services is associated with unequal patient utilization of optometrists, ophthalmologists and family doctors.
We compared the utilization of eye care providers (i.e. optometrists and ophthalmologists) and family doctors among Caucasians residing in provinces with and without government-insured optometric services. Derived data was based on self-reports from the Canadian Community Health Survey 2005 (n=132,221) collected by Statistics Canada. Optometrists and ophthalmologists were combined together because the survey question did not distinguish between them. Given the small sample size of non-Caucasians, they were excluded in order to make valid comparisons.
Among Caucasians without known eye disease, the utilization of eye care providers was lower in provinces with uninsured provincial optometric services (33.5%) versus provinces with government-insured optometric services (38.2%, p<0.05). Larger differences were found for people aged 12-17 (38.5% vs 47.7%, p<0.05) and 65+ (38.1% vs 51.5%, p<0.05).<br /> <br /> Among people aged 12 years and older who did not have a chronic condition and used an eye care provider in a 12-month period (i.e. they had an eye care need), 76.0% also used a family doctor if they resided in provinces with uninsured optometric services, compared to 70.2% (p<0.05) in provinces with government-insured optometric services. For those who did not have a chronic condition and did not use an eye care provider (i.e. they did not seem to have an eye care need), the utilization of a family doctor was 62.6% for uninsured provinces versus 61.6% for insured provinces (p>0.05). These results suggest that uninsured people with a vision concern are more likely to visit a family doctor rather than an optometrist. In both univariate and multivariate analyses, we observed about 5% (p<0.05) increased utilization of family doctors in the provinces with uninsured optometric services.
Lack of government-funded optometric services is associated with reduced utilization of eye care providers and increased utilization of family doctors. This is likely due to financial barriers inhibiting access to optometrists in provinces without insured optometric services.
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