Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, USA.
JAMA Ophthalmol. 2013 Apr;131(4):499-506. doi: 10.1001/jamaophthalmol.2013.1165.
To compare rates of eye care visits and vision impairment among working-age adults with vision insurance vs without, among the total sample of Behavioral Risk Factor Surveillance Survey respondents and among a subsample of respondents who had diagnoses of glaucoma, age-related macular degeneration (ARMD), and/or cataract.
Using the Behavioral Risk Factor Surveillance Survey 2008 vision module data, we examined the likelihood of an eye care visit within the past year and of self reported visual impairment among 27 152 adults aged 40 to 65 years and among a subset of 3158 persons (11.6%) with glaucoma, ARMD, and/or cataract. Multivariate logistic regression models were used.
About 40% of both the study population and the subsample with glaucoma, ARMD, and/or cataract had no vision insurance. Respondents with vision insurance were more likely than those without to have had eye care visits (general population adjusted odds ratio [AOR], 1.90 [95% CI, 1.89-1.90]; glaucoma-ARMD-cataract subsample AOR, 2.15 [95% CI, 2.13-2.17]), to have no difficulty recognizing friends across the street (general population AOR, 1.24 [95% CI, 1.22-1.26]; eye-disease subsample AOR, 1.45 [95% CI, 1.42-1.49]), and to have no difficulty reading printed matter (general population AOR, 1.34 [95% CI, 1.33-1.35]; eye-disease subsample AOR, 1.37 [95% CI, 1.34-1.39]). Respondents from the total sample who had an eye care visit were better able to recognize friends across the street (AOR, 1.07) and had no difficulty reading printed matter (AOR, 1.70), and respondents from the eye-disease subsample who had an eye care visit also were better able to recognize friends across the street (AOR, 1.71) and had no difficulty reading printed matter (AOR, 1.45).
Lack of vision insurance impedes eye care utilization, which, in turn, may irrevocably affect vision. Vision insurance for preventive eye care should cease to be a separate insurance benefit and should be mandatory in all health plans.
比较有视力保险和无视力保险的工作年龄成年人的眼部护理就诊率和视力障碍率，包括行为风险因素监测调查的所有受访者样本和青光眼、年龄相关性黄斑变性 (ARMD) 和/或白内障诊断的受访者亚组。
利用行为风险因素监测调查 2008 年视力模块数据，我们检查了过去一年中进行眼部护理就诊的可能性以及 27152 名 40 至 65 岁成年人和 3158 名（11.6%）青光眼、ARMD 和/或白内障患者报告的视觉障碍。使用多变量逻辑回归模型。
大约 40%的研究人群和青光眼、ARMD 和/或白内障的亚组都没有视力保险。有视力保险的受访者比没有视力保险的受访者更有可能进行眼部护理就诊（普通人群调整后的优势比 [AOR]，1.90 [95%CI，1.89-1.90]；青光眼-ARMD-白内障亚组 AOR，2.15 [95%CI，2.13-2.17]），能够轻松认出街对面的朋友（普通人群 AOR，1.24 [95%CI，1.22-1.26]；眼病亚组 AOR，1.45 [95%CI，1.42-1.49]），并且能够轻松阅读印刷品（普通人群 AOR，1.34 [95%CI，1.33-1.35]；眼病亚组 AOR，1.37 [95%CI，1.34-1.39]）。来自总样本的进行眼部护理就诊的受访者能够更轻松地认出街对面的朋友（AOR，1.07），并且阅读印刷品没有困难（AOR，1.70），来自眼病亚组的进行眼部护理就诊的受访者也能够更轻松地认出街对面的朋友（AOR，1.71），并且阅读印刷品没有困难（AOR，1.45）。
缺乏视力保险会阻碍眼部护理的利用，这反过来又可能不可逆转地影响视力。预防眼部护理的视力保险不应再作为单独的保险福利，而应成为所有健康计划的强制性要求。
