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加拿大的眼科保健利用及其决定因素。

Eye care utilization and its determinants in Canada.

机构信息

Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ont.

Department of Ophthalmology, Université de Montréal, Montreal, Que; Hôpital Maisonneuve-Rosemont, Montreal, Que.

出版信息

Can J Ophthalmol. 2018 Jun;53(3):298-304. doi: 10.1016/j.jcjo.2018.01.021. Epub 2018 Mar 9.

Abstract

OBJECTIVE

To provide the frequency and potential determinants of eye care utilization over the last 12 months among Canadians between the ages of 45 and 85 years old.

DESIGN

Cross-sectional population-based study.

PARTICIPANTS

30,097 people in the Comprehensive Cohort of the Canadian Longitudinal Study on Aging.

METHODS

Inclusion criteria included being between the ages of 45 and 85 years old, community-dwelling and living near one of the 11 data collection sites across 7 Canadian provinces. Eye care utilization was defined as the self-report of a visit to an optometrist or ophthalmologist in the past 12 months.

RESULTS

In the last year, 57% of 28 728 adults visited an eye care provider although there was heterogeneity between provinces. The highest eye care utilization was found in Ontario at 62%, whereas the lowest was in Newfoundland and Labrador at 50%. Of concern, 25.3% of people with diabetes above the age of 60 years had not seen an eye care provider in the last year. Our novel finding was that current smokers were less likely to use eye care compared to never smokers (odds ratio [OR] = 0.76, 95% confidence interval [CI] 0.67-0.87). Confirming previous research, men compared to women (OR = 0.67, 95% CI 0.62-0.71), people with less than a bachelor's degree compared to more than a bachelor's degree (OR = 0.87, 95% CI 0.79-0.95), and people making less income (linear trend p < 0.05) were less likely to use eye care.

CONCLUSIONS

Disparities exist in eye care utilization in Canada. Efforts should be made to reduce these disparities to reduce avoidable vision loss.

摘要

目的

调查 45 至 85 岁加拿大人群在过去 12 个月中进行眼科保健的频率和潜在决定因素。

设计

基于人群的横断面研究。

参与者

加拿大老龄化纵向研究综合队列中的 30097 人。

方法

纳入标准包括年龄在 45 至 85 岁之间、居住在社区且居住在加拿大 7 个省的 11 个数据采集点之一附近。眼科保健利用度定义为过去 12 个月内曾自行前往验光师或眼科医生就诊。

结果

在过去的一年中,尽管各省之间存在差异,但 28728 名成年人中有 57%曾就诊于眼科保健提供者。眼科保健利用率最高的是安大略省(62%),而纽芬兰和拉布拉多省(50%)最低。令人担忧的是,60 岁以上患有糖尿病的人群中,有 25.3%的人在过去一年中未就诊于眼科保健提供者。我们的新发现是,与从不吸烟者相比,当前吸烟者使用眼科保健服务的可能性较小(比值比 [OR] = 0.76,95%置信区间 [CI] 0.67-0.87)。与先前的研究一致,男性与女性相比(OR = 0.67,95%CI 0.62-0.71)、未获得学士学位者与获得学士学位以上者相比(OR = 0.87,95%CI 0.79-0.95)、收入较低者(线性趋势 p < 0.05)使用眼科保健服务的可能性较小。

结论

加拿大的眼科保健利用度存在差异。应努力减少这些差异,以减少可避免的视力丧失。

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