July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Differences in Receiving Eye Care Based on Dementia Status
Author Affiliations & Notes
  • Suzann Pershing
    Stanford University, Stanford, California, United States
  • Mary K. Goldstein
    Stanford University, Stanford, California, United States
  • Victor W. Henderson
    Stanford University, Stanford, California, United States
  • Ying Lu
    Stanford University, Stanford, California, United States
  • M. Kate Bundorf
    Stanford University, Stanford, California, United States
  • Moshiur Rahman
    University of Michigan, Michigan, United States
    Stanford University, Stanford, California, United States
  • Chris Andrews
    University of Michigan, Michigan, United States
  • Joshua D Stein
    University of Michigan, Michigan, United States
  • Footnotes
    Commercial Relationships   Suzann Pershing, None; Mary K. Goldstein, None; Victor W. Henderson, None; Ying Lu, None; M. Kate Bundorf, None; Moshiur Rahman, None; Chris Andrews, None; Joshua Stein, None
  • Footnotes
    Support  National Institute on Aging (R03-AG056453), National Eye Institute P30-EY026877, Research to Prevent Blindness, Inc.
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 5446. doi:
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    • Get Citation

      Suzann Pershing, Mary K. Goldstein, Victor W. Henderson, Ying Lu, M. Kate Bundorf, Moshiur Rahman, Chris Andrews, Joshua D Stein; Differences in Receiving Eye Care Based on Dementia Status. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5446.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate the relationship between presence of dementia and likelihood of seeing an eye care provider. There are growing numbers of older adults with dementia, who are also at risk for aging-related eye diseases that substantially affect quality of life. Ophthalmic care is important for timely diagnosis and management of these diseases. However, little is known about access to eye care among this group.

Methods : We used administrative insurance claims for a 20% representative sample of US Medicare beneficiaries receiving care between January 1, 2006, and December 31, 2015. Dementia was identified from International Classification of Diseases, 9th and 10th editions, diagnosis codes. We used multivariable Cox proportional hazards regression models to evaluate the hazard of receiving eye care among patients with dementia, versus those without. Models were adjusted for potential confounders, including demographics, urban/rural residence, analysis year, overall systemic health, and ocular comorbidities. We specifically evaluated 1) hazard of being seen by any eye care provider (ophthalmologist or optometrist), as well as 2) hazard of being seen specifically by an ophthalmologist (adjusting for any optometrist visits).

Results : 3,603,877 patients met study inclusion criteria, 584,520 with a dementia diagnosis. 70.0% of dementia patients were seen by an eye care provider during the study period, versus 75.6% of nondementia patients. Compared to nondementia patients, dementia patients had lower likelihood of being seen by any eye care provider (adjusted HR=0.79, 95%CI 0.79-0.80) and were even less likely to be seen by an ophthalmologist (adjusted HR=0.65, 95%CI 0.64-0.65). Patients previously seen by an optometrist were less likely to be seen by an ophthalmologist (HR=0.63, 95%CI 0.62-0.63), but this effect was less pronounced among dementia compared to nondementia patients (HR=0.73, 95%CI 0.72-0.74 for ophthalmologist visits among dementia patients with optometry visits, versus HR=0.62, 95%CI 0.62-0.62, among nondementia patients with optometry visits).

Conclusions : US Medicare patients with dementia are less likely to be seen by eye care providers than those without dementia. This finding has implications for access and quality of care. More information is necessary to understand the reasons underlying disparities in receipt of eye care services.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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