Kemper Alex R, Bruckman David, Freed Gary L
The Child Health Evaluation and Research (CHEAR) Unit, Division of General Pediatrics, University of Michigan, Ann Arbor 48109-0456, USA.
Optom Vis Sci. 2004 Jan;81(1):7-10. doi: 10.1097/00006324-200401000-00003.
No population-based data are available regarding the proportion of school-age children who have corrective lenses in the U.S. The objective of this study was to quantify the proportion of children who have corrective lenses (glasses or contact lenses) and to evaluate the association of corrective lenses with age, gender, race/ethnicity, health insurance status, and family income.
Children 6 to 18 years of age were identified in the 1998 Medical Expenditure Panel Survey. National estimates were made of the proportion with corrective lenses. Logistic regression modeling was used to assess factors that were associated with corrective lenses.
Based on the 5,141 children in the 1988 Medical Expenditure Panel Survey, an estimated 25.4% of the 52.6 million children between 6 and 18 years had corrective lenses. Girls had greater odds than boys of having corrective lenses (odds ratio, 1.41; p < 0.001). Insured children, regardless of race/ethnicity, and uninsured nonblack/non-Hispanic children had similar odds of having corrective lenses. Compared with uninsured black or Hispanic children (odds ratio, 1), greater odds of corrective lens use was found among uninsured nonblack/non-Hispanic children (odds ratio, 2.29; p = 0.002) and black or Hispanic children with public (odds ratio, 1.67; p = 0.005) or private health insurance (odds ratio,1.77; p = 0.004). Among families with an income > or =200% of the federal poverty level, the odds of having corrective lenses increased with age (p < or = 0.04). In contrast, among those families <200% of the federal poverty level, the odds of having corrective lenses at 12 to 14 years was similar to 15- to 18-year olds (p = 0.93).
The use of corrective lenses suggests that correctable visual impairment is the most common treatable chronic condition of childhood. Income, gender, and race/ethnicity, depending on insurance status, are associated with having corrective lenses. The underlying causes and the impacts of these differences must be understood to ensure optimal delivery of eye care.
在美国，尚无基于人群的关于学龄儿童佩戴矫正眼镜比例的数据。本研究的目的是量化佩戴矫正眼镜（眼镜或隐形眼镜）的儿童比例，并评估矫正眼镜与年龄、性别、种族/族裔、健康保险状况及家庭收入之间的关联。
在1998年医疗支出小组调查中确定了6至18岁的儿童。对佩戴矫正眼镜的比例进行了全国性估计。采用逻辑回归模型评估与矫正眼镜相关的因素。
基于1998年医疗支出小组调查中的5141名儿童，估计在5260万6至18岁的儿童中，有25.4%佩戴矫正眼镜。女孩佩戴矫正眼镜的几率高于男孩（优势比，1.41；p<0.001）。无论种族/族裔如何，参保儿童以及未参保的非黑人/非西班牙裔儿童佩戴矫正眼镜的几率相似。与未参保的黑人或西班牙裔儿童相比（优势比，1），未参保的非黑人/非西班牙裔儿童（优势比，2.29；p = 0.002）以及有公共（优势比，1.67；p = 0.005）或私人健康保险的黑人或西班牙裔儿童（优势比，1.77；p = 0.004）佩戴矫正眼镜的几率更高。在收入≥联邦贫困水平200%的家庭中，佩戴矫正眼镜的几率随年龄增加而升高（p≤0.04）。相比之下，在收入<联邦贫困水平200%的家庭中，12至14岁儿童佩戴矫正眼镜的几率与15至18岁儿童相似（p = 0.93）。
矫正眼镜的使用表明可矫正视力障碍是儿童期最常见的可治疗慢性病。收入、性别以及种族/族裔（取决于保险状况）与佩戴矫正眼镜有关。必须了解这些差异的潜在原因及其影响，以确保提供最佳的眼科护理。
