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Kunyong Xu, Graham E. Trope, Ray J. Buncic, Yaping Jin; Inequities in Eye Care Utilization among Canadian Adolescents: Evidence from the Canadian Community Health Survey. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6322.
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Many but not all Canadian provincial health insurance plans cover eye care services for children younger than 18 years of age. We examined how provincial eye care coverage and selected socio-demographic and health factors affect adolescent’s access to eye care providers.
Data was collected from the Canadian Community Health Survey 2007/2008. Utilization of eye care services was measured using the question "In the past 12 months, have you seen, or talked to an eye specialist, such as an ophthalmologist or optometrist?" Respondents aged 12-17 were included in the analysis (n=11,015). Associations of interest were assessed by prevalence ratios (PR).
Canada wide, 45.6% of adolescents utilized eye care services over a 12 month period. Utilization varied greatly by geographic location: significantly higher (46.4%) in provinces with eye care coverage, lower (35.9%) in provinces with partial or no coverage, and lowest (27.1 %) in the three territories with a dearth of eye care professionals. Compared to adolescents in provinces with eye care coverage, those with partial or no coverage were 24% less likely to utilize services (PR=0.76, 95% confidence interval (CI): 0.67-0.85); whereas those in the three territories were nearly 40% less likely to utilize eye care providers (PR=0.63, 95% CI: 0.48-0.83). Significantly lower utilization rates were also found among males (10% less likely than females), those with dwellings not owned by a member of the household (19% less likely than those owned), and those reading less than 3 hours weekly (13% less likely than those reading 3 or more hours) not counting school reading. Adolescents with diabetes were 67% more likely to utilize eye care services (PR=1.67, 95% CI: 1.29-2.15) than those unaffected. Lower level of household highest education, spending less than 1 hour on a computer weekly, and having children aged 5 or younger in the household were all associated with a non-statistically significant reduction in utilizing eye care services.
Inequities in eye care utilization were observed amongst Canadian adolescents. Factors associated with significantly less utilization were: partial or no provincial eye care coverage, lack of eye care professionals, male gender, living in dwellings not owned, non-diabetic, and spending less time reading.
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