Uninsured Americans Less Likely To Receive Eye Care Than Canadians And Insured Americans

In
comparison with Canadians, Americans with vision problems are equally
or more likely to access eye care services, if they have health
insurance. Without health insurance, Americans visit eyecare
professionals at lower rates, according to a report released August 11,
2008 in the Archives of Ophthalmology, one of the JAMA/Archives
journals.

The
article highlights barriers to access to regular eye care in both
countries: “In both Canada and the United States, general health
insurance covers
medical payment for eye injury and various eye diseases such as
cataract, glaucoma and diabetic retinopathy, and optional vision
insurance provides additional insurance coverage for eye examinations,
contact lenses and eyeglasses and/or frames, and, in some instances,
part of the costs for elective laser surgery for vision correction.”
They continue, noting that “many Americans and Canadians have publicly
funded
or private coverage for optional vision care.”

In order to
analyze the differences between eye care access in Canada and the
United States, particularly in light of health insurance status, Xinzhi
Zhang,
M.D., Ph.D., of the Centers for Disease Control and Prevention (CDC) in
Atlanta and colleagues, conducted a survey to examine disparities in
eye care service use in 2,018 Canadians and 2,930 Americans with vision
problems between 2002 and 2003.

Of
the Americans with vision problems surveyed 8.2% did not have health
insurance. This group had the lowest eye care service rate, defined as
a visit to an eye care professional in the last year, with 42%. In
contrast, Americans with private health insurance had a service rate of
67% and Canadians had a rate of 55%.?�A higher likelihood of
eye
care service use was associated with higher incomes and with optional
vision insurance. The authors summarize: “The difference in use of eye
care services
between Americans without health insurance and Canadians narrowed when
adjusted for income level and was almost eliminated when adjusted for
having optional vision insurance.”

The authors conclude that the gap in health insurance status
contributes significantly to the disparity in eye care. “Among
adults with vision problems, a public health gap exists in actual
access to eye care services between Canada and the United States,
primarily owing to the population without health insurance in the
United States,” they say. “However, although health insurance is
associated with increased use of preventive services and recommended
treatments, simply providing health insurance to all persons may be
insufficient to increase the percentage of individuals who use eye care
services or to improve vision-related outcomes; economic status and
optional vision insurance are also significantly associated with rates
of use of eye care services.”

They
conclude that, to provide effective interventions in eye care,
officials should take an approach that targets low income
groups:?�“Therefore, public health
interventions targeting adults with vision problems without health
insurance might be more beneficial if they focused on those at risk for
serious vision loss, especially those in the lowest income group.”

Health Insurance Coverage and Use of Eye Care Services
Xinzhi
Zhang, MD, PhD; Paul P. Lee, MD, JD; Theodore J. Thompson, MS; Sanjay
Sharma, MD, MS, MBA; Lawrence Barker, PhD; Linda S. Geiss, MA;
Giuseppina Imperatore, PhD; Edward W. Gregg, PhD; Xuanping Zhang, PhD;
Jinan B. Saaddine, MD, MPH
Arch Ophthalmol. 2008;126(8):1121-1126.
Click
Here For Abstract

Anna Sophia McKenney