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S.H. Paz, J. Wu, S.P. Azen, R. Varma, Los Angeles Latino Eye Study group; Eye Care Utilization and Indicators in Latinos: The Los Angeles Latino Eye Study (LALES) . Invest. Ophthalmol. Vis. Sci. 2005;46(13):1165.
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Purpose: To assess the utilization of eye care services and the risk indicators for not obtaining eye care in a population–based sample of Latinos. Methods: The LALES assessed the prevalence of eye disease, quality of life, and utilization of eye care in a population–based sample of Latinos (primarily Mexican–Americans). A detailed interview and eye examination were performed on each participant. In addition to assessing utilization of eye care, we were able to explore the following potential indicators for not obtaining eye care following the American Academy of Ophthalmology's Vision Care Guidelines (AAO VCG): Predisposing characteristics (eg: age, gender); Enabling characteristics – (eg: income, health insurance, vision isurance); Need characteristics – (eg: co–morbidities, visual impairment, history or presence of eye disease); and Health behavior characteristics – (eg: smoking, alcohol use). Non–compliance with AAO VCG was defined as: 1) in persons 40 to < 65 years of age who did not have a dilated eye examination (DEE) in the 5 years preceding the LALES examination or 2) in persons >65 years of age who did not have a DEE in the 3 years preceding the LALES examination. Logistic regression was used to evaluate the association between predisposing, enabling, need, and health behavior factors and the likelihood of non–compliance with AAO VCG. Results: Of the 4329 participants who had completed utilization data, 2046 (47%) had never had a DEE. An additional 1803 (42%) had complied with AAO VCG and 480 (11%) had a DEE outside the time requirement of the AAO VCG. Risk indicators independently associated with non–compliance were: 1) predisposing: younger than age 65 years (OR=1.4; 95% CI=1.2,1.7), male gender (OR=1.3; 1.1,1.5), less than high school education (OR=1.4; 1.2,1.7); 2) enabling: lacking vision insurance (OR=1.6; 1.4,1.9), not usually seeing one health professional (OR=1.3; 1.2,1.6); 3) need: having poor to fair general vision (OR=1.3; 1.1,1.5); 4) health behaviors: alcohol drinker (OR=1.4; 1.1,1.8), and never had a routine physical exam (OR=1.7; 1.3,2.3). Conclusions: A significant number of Latinos (almost half ) never had a complete eye examination and a majority (58%) of the cohort did not follow AAO VCG. Given the significant burden of visual impairment and eye disease in Latinos, it is important to consider incorporating various modifiable characteristics (education, vision insurance, and having a regular doctor or health professional usually seen) in programs targeted at decreasing the burden of visual impairment and eye diseases in Latinos.
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