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S. Arora, D. J. Lee, B. Lam, D. D. Zheng, K. L. Arheart, S. L. Christ, A. J. Caban-Martinez; Reported Eye Care Utilization Among US Adults: The 1997-2005 National Health Interview Survey. Invest. Ophthalmol. Vis. Sci. 2007;48(13):333.
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Rates of eye care utilization (ECU) among US adults are unavailable in many race and ethnic subgroup categories. This study examines ECU using data representative of the US population aged 18 years and older.
The National Health Interview Survey (NHIS) is a population-based annual survey of the US non-institutionalized civilian population. Nearly 290,000 adults 18 years of age and older participated in the NHIS from 1997-2005. Participants were asked, "Do you have any trouble seeing, even when wearing glasses or contact lenses?" (mild/moderate VI), and "Are you blind or unable to see at all? (severe VI). Participants were also asked, "During the past 12 month have seen or talked to any optometrist, ophthalmologist, or eye doctor?" Participants were classified as having utilized eye care if they responded yes to the question. SAS survey procedures were used to compute 1997-2005 pooled eye care utilization rates adjusted for survey weights and design effects.
The overall ECU rates were 58.3% [95% confidence interval: 55.0-61.5] for severe VI, 49.6% [48.8-50.4] for some VI, and 33.7% [33.3-34.0] for no VI. Within VI categories the prevalence of ECU without health insurance was markedly lower for participants (33.3%, 24.7%, and 13.5%), was greater in older versus younger adults, in females versus males, and in participants with more than a high school education versus adults reporting less education. There were no large differences in ECU prevalence across US race groups. Hispanics reporting no VI reported lower rates of ECU relative to non-impaired non-Hispanics with the lowest rates reported by Mexican-Americans (17.1%). Compared to non-Hispanics and other Hispanics, Mexican-Americans with severe VI or some VI reported the lowest rates of ECU: 46.1% and 36.1%, respectively.
Rates of reported ECU was higher in participants with more severe VI, older participants, females, and those with higher levels of educational attainment. Irrespective of VI status, ECU rates are at least 50% lower in adults without health insurance. Interventions designed to increase the number of men, Mexican-Americans and those with a high school education or less undergoing routine eye examinations are warranted. ECU utilization rates would also be improved if the number of Americans without health insurance could be reduced.
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