Academic Unit of Public Health, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
Bradford School of Optometry and Vision Science, University of Bradford, Bradford, UK.
J Public Health (Oxf). 2018 Jun 1;40(2):e171-e179. doi: 10.1093/pubmed/fdx058.
Small-area analysis of National Health Service (NHS)-funded sight test uptake in Leeds showed significant inequalities in access among people aged <16 or ≥60.
Data were extracted from 604 126 valid General Ophthalmic Services (GOS)1 claim forms for eye examinations for Essex residents between October 2013 and July 2015. Expected GOS1 uptake for each lower super output area was based on England annual uptake. Poisson regression modelling explored associations in GOS1 uptake ratio with deprivation.
People aged ≥60 or <16 living in the least deprived quintile were 15% and 26%, respectively, more likely to have an NHS funded eye examination than the most deprived quintile, although all are equally entitled. GOS1 uptake is higher in the more deprived quintiles among 16-59-year old, as means tested social benefits are the main eligibility criteria in this age-group. Inequalities were also observed at local authority level.
Inequalities in access among people ≥60 years were not as large as those reported in Leeds, although inequalities in <16-year old were similar. However, demonstrable inequalities in this data set over a longer time period and a larger and more diverse area than Leeds, reinforce the argument that interventions are needed to address eye examination uptake inequalities.
利兹地区国民保健服务（NHS）资助的视力检查接受情况的小范围分析显示，16 岁以下或 60 岁以上人群的就诊机会存在显著差异。
从 2013 年 10 月至 2015 年 7 月期间，埃塞尔郡居民的 604126 份有效一般眼科服务（GOS）1 检查申请表格中提取数据。每个较低的超级输出区域的预期 GOS1 接受率基于英格兰的年度接受率。泊松回归模型探索了 GOS1 接受率与贫困程度之间的关联。
在最不贫困的五分之一中，年龄在 60 岁及以上或<16 岁的人群接受 NHS 资助的眼部检查的可能性分别比最贫困的五分之一高出 15%和 26%，尽管所有人都有平等的权利。在 16-59 岁的人群中，在较贫困的五分之一中，GOS1 的接受率更高，因为这一年龄组的主要资格标准是经济状况调查的社会福利。在地方当局一级也观察到了不平等现象。
60 岁以上人群的就诊机会不平等程度不如利兹报道的那么大，尽管<16 岁人群的不平等程度相似。然而，在这个数据集上，更长的时间跨度和更大、更多样化的地区比利兹报告的不平等现象更明显，这加强了需要采取干预措施来解决眼部检查接受不平等的论点。
