Abstract
Purpose :
Eye exams by an optometrist or ophthalmologist (termed “eye care providers” (ECPs)) are required to obtain prescription eyewear (eyeglasses and contact lenses), which can be expensive and are not usually publicly funded. In 2004, government-funded routine eye exams were delisted for Ontarians aged 20-64 leaving coverage only for those aged ≤19 and 65+. We assessed whether eyewear insurance impacts the utilization of ECPs in Ontario.
Methods :
We analyzed data from Ontarians aged 12+ responding to the Canadian Community Health Survey in 2003, 2005, and 2013/2014. We compared the utilization of ECPs by eyewear insurance status and eligibility for government-funded eye exams, using univariate analyses and adjusting for confounding effects using multivariable analyses. Only respondents without diabetes were included as diabetic eye care was insured for all age groups in all survey years.
Results :
The utilization of ECPs was significantly higher in Ontarians aged 12+ with eyewear insurance than those without (42.1% vs 37.4% in 2003, 42.4% vs 37.5% in 2005, and 44.0% vs 35.9% in 2013/2014; p<0.05 for all). This higher level of utilization was seen in age groups with (12-19 and 65+) and without (20-64) government-funded eye exams. The difference between individuals with and without eyewear insurance was particularly evident among those aged 20-64 in 2013/2014, when this group no longer had government-funded eye exams (34.9% vs 19.9%, a gap of 15.0%, (p<0.05) among 20-39-year-olds and 43.4% vs 32.9%, a gap of 10.5%, (p<0.05) among 40-64-year-olds). In comparison, this difference was 51.9% vs 46.3% (a gap of 5.6%, p<0.05) among those aged 12-19 and 66.6% vs 59.1% (a gap of 7.5%, p<0.05) among those aged 65+ in 2013/2014. Adjusting for confounding effects, the likelihood of utilizing an ECP was greater among individuals with eyewear insurance than those without (adjusted prevalence ratio of 1.41 for those aged 20-64, and 1.10 for those aged 65+; p<0.05 for both).
Conclusions :
Lack of insurance coverage for prescription eyewear negatively impacts the utilization of ECPs, even among those eligible for government-funded routine eye exams (12-19 and 65+). This result suggests that the cost of eye exams may not be the only financial barrier influencing the decision to undergo vision assessment.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.