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Y. P. Jin, G. E. Trope; Unequal Eye Care Utilization in Canada: A Comparison With Dental Care. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2503.
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1) To examine eye care utilization patterns across different sociodemographic groups under Canadian universal health coverage; 2) To evaluate how often Canadians utilize government sponsored eye care services versus privatized dental care services.
We analyzed data from 132,221 people aged 12 years or older from the Canadian Community Health Survey 2005. Eye care and dental care utilization was defined as self-reported having seen or talked on the telephone with an eye specialist (ophthalmologists or optometrists) or a dentist or orthodontist over a 12-month period. Prevalence ratios (PRs), not odds ratios, derived from log-Poisson regression model were used to measure the associations of interest due to the common occurrence of outcome.
Canadians aged 12 years or older utilized dentists (64%) more often than eye specialists (40%) (P<0.05).Utilization of eye specialists was not related to education level nor total household income in those aged 40 years or over with self-reported glaucoma, cataract or diabetes. Among people without these three conditions, a significantly lower likelihood of using eye specialists was found in men than in women, in people with education levels less than post-secondary, and in those with total household incomes less than $30,000. Disregarding the status of glaucoma, cataract or diabetes, Canadians residing in Newfoundland and Labrador were significantly less likely to utilize eye specialists than those residing in other Canadian provinces. This gap is especially remarkable among seniors without the three mentioned conditions (adjusted PR=0.60, 95% confidence interval 0.51-0.71). In Ontario and Prince Edward Island, 4% of glaucoma patients, 11% of diabetes, and 15% of people aged 65 years or older had not had an eye exam for 2 years or more.
Marked disparities were found in eye care utilization despite universal health coverage in Canada. Among people without self-reported glaucoma, cataract and diabetes, men, those with lower levels of education and income and those residing in Newfoundland and Labrador utilized eye specialists least. A substantial proportion of people at high risk of vision loss (glaucoma, diabetes and aged ≥65 years) had not seen an eye specialist for 2 years or more. Overall, Canadians utilized dentists more often than eye specialists.
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