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L. E. Patty, L. S. Morales, M. Lai, R. Varma, S. Azen, the LALES Group; Self-Reported Utilization of Eye Care Among Latinos in the Los Angeles Latino Eye Study (LALES). Invest. Ophthalmol. Vis. Sci. 2009;50(13):2502.
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© ARVO (1962-2015); The Authors (2016-present)
To identify determinants of eye care utilization in the Los Angeles Latino Eye Study (LALES)
The LALES is a large population-based study in Los Angeles that collected survey and examination data from a cross-section of Latinos ages 45 years and older, including self-reported survey questions about access to general medical care and eye care. Participants underwent a detailed in-home interview to obtain demographic information, risk factors, history of ocular and medical conditions, utilization of care, acculturation, and insurance status. A subsequent dilated eye examination along with blood pressure, random glucose, and vision testing was performed in a standardized manner at the LALES Local Eye Examination Center. Univariate and multivariate logistic regression analyses were conducted to identify associations between predisposing, enabling, and need variables, as defined by Andersen’s Behavioral model, and determinants of eye care utilization among Latinos living in La Puente, California.
Overall, 36% of study participants reported an eye care visit in the past 12 months, 57% reported ever having a dilated eye exam, and 19% reported a dilated eye exam in the past 12 months. Increased eye care utilization was associated with greater age (OR 4.33, CI 3.66-5.13), greater number of medical comorbidities (OR 1.42, CI 1.35- 1.49), female gender (OR 1.14, CI 1.02-1.28), bilingual language proficiency (English and Spanish) (OR 1.90, CI 1.59-2.27), more education (OR 2.26, CI 1.87-2.73), having health insurance (OR 2.57, CI 2.27-2.90), having a usual place for care (OR 2.25, CI 1.98-2.56), having a regular provider of care (OR 2.35, CI 2.10-2.64), near and distance vision impairment (OR 0.77, CI 0.67-0.88 and OR 1.49, CI 1.18-1.89, respectively), and lower National Eye Institute Vision Functioning Questionnaire-25 scores (OR 0.99, CI 0.98-0.99).
In general, Latinos at higher risk for eye disease (older, greater number of comorbidities, impaired near and distance vision) utilize eye care at a much lower level than recommended by American Academy of Ophthalmology guidelines. Health care initiatives with special attention to increasing access to eye care for those with less education and lack of insurance would likely have a large impact on identifying and treating undetected eye disease. Increasing utilization of eye care services should be a priority given the significant impacts of visual impairment on health related quality of life and mortality in this population.
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