Centre for Health Policy, Programs and Economics School of Population Health, Faculty of Medicine, Dentistry and Health Sciences University of Melbourne, 207 Bouverie st Parkville, Melbourne, 3010, Australia.
BMC Ophthalmol. 2012 Sep 24;12:51. doi: 10.1186/1471-2415-12-51.
This project is a community-level study of equity of access to eye health services for Indigenous Australians.
The project used data on eye health services from multiple sources including Medicare Australia, inpatient and outpatient data and the National Indigenous Eye Health Survey.The analysis focused on the extent to which access to eye health services varied at an area level according to the proportion of the population that was Indigenous (very low = 0-1.0%, low = 1.1-3.0%, low medium = 3.1-6.0%, high medium = 6.1-10.0%, high = 10.1-20.0%, very high = 20 + %). The analysis of health service utilisation also took into account age, remoteness and the Socioeconomic Indices for Areas (SEIFA).
The rate of eye exams provided in areas with very high Indigenous populations was two-thirds of the rate of eye exams for areas with very low indigenous populations. The cataract surgery rates in areas with high medium to very high Indigenous populations were less than half that reference areas. In over a third of communities with very high Indigenous populations the cataract surgery rate fell below the World Health Organization (WHO) guidelines compared to a cataract surgery rate of 3% in areas with very low Indigenous populations.
There remain serious disparities in access to eye health service in areas with high Indigenous populations. Addressing disparities requires a co-ordinated approach to improving Indigenous people's access to eye health services. More extensive take-up of existing Medicare provisions is an important step in this process. Along with improving access to health services, community education concerning the importance of eye health and the effectiveness of treatment might reduce reluctance to seek help.
本项目是对澳大利亚原住民获得眼保健服务机会公平性的社区层面研究。
该项目使用了来自多个来源的眼保健服务数据，包括澳大利亚医疗保险、住院和门诊数据以及国家原住民眼健康调查。该分析主要关注在人口中土著居民比例不同的地区（非常低=0-1.0%、低=1.1-3.0%、低中=3.1-6.0%、中高=6.1-10.0%、高=10.1-20.0%、非常高=20%+），按比例计算，获得眼保健服务的程度有何差异。卫生服务利用的分析还考虑了年龄、偏远程度和社会经济地区指数（SEIFA）。
在土著居民比例非常高的地区，提供的眼部检查率是土著居民比例非常低的地区的三分之二。中高至高土著居民比例地区的白内障手术率不到参考地区的一半。在三分之一以上的土著居民比例非常高的社区，白内障手术率低于世界卫生组织（WHO）的指导方针，而土著居民比例非常低的地区的白内障手术率为 3%。
在土著居民比例较高的地区，获得眼保健服务的机会仍然存在严重差距。要解决差距问题，需要协调一致地改善原住民获得眼健康服务的机会。更广泛地利用现有的医疗保险规定是这一进程中的重要一步。除了改善获得卫生服务的机会外，社区教育应关注眼健康的重要性和治疗的有效性，这可能有助于减少寻求帮助的抵触情绪。
