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Preeti Gupta, Shivani Majithia, Alfred Gan, Eva K Fenwick, Stanley Poh, Charumathi Sabanayagam, Tien Y Wong, Yih Chung Tham, Ching-Yu Cheng, Ecosse Luc Lamoureux; Prevalence and Determinants of Eyecare Utilization and Eyeglass Affordability in a Population-based Study of Ethnic Singaporeans. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1019.
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© ARVO (1962-2015); The Authors (2016-present)
The use of eyecare services plays a key role in national eye health. Estimates of eyecare utilization and their associated determinants are, however, unavailable among Singaporeans. In this study, we determined the prevalence and potential determinants of eyecare utilization and spectacle affordability among Singaporeans.
From the Singapore Epidemiology of Eye Diseases Study, a population-based cross-sectional study of Chinese, Malays and Indians, we included adults who attended the 6-year follow-up and had answered the following questions (a) “How often do you have your eyes checked?” and among those who wore glasses (b) “In comparison to your income, are glasses expensive?” Good eyecare utilization and affordability of eyeglass were defined as self-reported eye checks of at least once a year compared to occasional or no checks, and glasses being rated as not expensive or cheap as opposed to too expensive to afford or expensive but affordable, respectively. Multivariable logistic regression models were used to study the factors associated with eyecare utilization and eyeglass affordability.
We included 5677 adults (1776 Malays, 1674 Indians and 2227 Chinese; mean age [SD]: 63.5 [9.5] years; 52.0% female) who completed the requisite questions. Of these, 4642 (81.8%) wore glasses. Malays had the lowest standardized prevalence of good eyecare utilization (55%, 95% confidence interval [CI] 50.0-60.7) and had most difficulty affording eyeglass (33.2% [28.1-39.2]), followed by Chinese (eyecare utilization: 69.1% [48.8-100.0]; eyeglass affordability: 34.5% [26.4-64.7]) and Indians (eyecare utilization: 74.5% [64.4-86.4]; eyeglass affordability: 41.9% [33.3-52.9]), respectively. Younger age, males, Malay ethnicity, low socioeconomic status, non-professionals, poor vision, absence of private health insurance, glasses, diabetes, and lesser awareness of eye conditions were independently associated with poor utilization of eyecare. Older age, females, Malay and Indian ethnicities, and greater awareness of eye conditions, were associated with difficulty affording glasses.
Ethnic disparities exist in eyecare utilization and eyeglass affordability among Singaporeans. Strategies such as tailored eyecare utilization awareness campaign and subsidized spectacles for the Malay community to reduce these ethnic-specific variabilities are urgently needed.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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