Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Social Aspects of Public Health, Human Sciences Research Council, Cape Town, South Africa.
BMC Health Serv Res. 2020 Aug 17;20(1):756. doi: 10.1186/s12913-020-05621-8.
Eye examinations are recommended for all persons throughout life. However, there is disparity in the uptake of eye care services in different populations. Using data from a nationally representative population-based cross-sectional study (the South African National Health and Nutrition Examination Survey, [SANHANES-1]), this paper investigates the utilization of eye care services and its associated factors in South Africa.
Participants aged 15 years and older who participated in interviews and clinical examination were enrolled in the SANHANES from 2011 to 2012. Eye care utilization was assessed from participants' responses to whether they had their eyes examined by a medical professional and when they were last examined. Data were analysed using multiple logistic regression models employing a hierarchical approach to add predisposing (e.g. age, sex), enabling (e.g. health insurance) and need (e.g. hypertension) factors sequentially.
The study sampled 3320 participants, with 64.9% being females. 73.4% (95% CI [69.7-76.7]) of participants had never had an eye examination. After statistical adjustment, age groups (compared with 15-29 years: 30-44 years Odds Ratio [OR] = 1.76; 45-59 years OR = 2.13; 60-74 years OR = 2.74; ≥75 years OR = 3.22), ethnicity (compared with African descent: white OR = 4.71; mixed-race OR = 1.87; Indian OR = 7.67), high risk alcohol use (OR = 1.83), wealth index (compared with lowest quintile: third quintile OR = 1.75; fourth quintile OR = 2.23; fifth quintile OR = 2.49), health insurance (OR = 2.19), diabetes (OR = 1.75), high cholesterol (OR = 2.51), having assessed healthcare in the past 5 years (OR = 2.42), and self-reported vision problems (OR = 1.51) were significantly associated with eye care utilization.
Almost three-quarters of South Africans sampled were not utilizing eye care services. It is imperative to strengthen current public health measures (including eye health promotion programs) to address the alarmingly low uptake of eye care services as well as the disparities in eye care utilization in South Africa.
建议所有人在一生中都进行眼部检查。然而，不同人群对眼部保健服务的利用率存在差异。本研究使用来自全国代表性的基于人群的横断面研究（南非国家健康和营养调查，[SANHANES-1]）的数据，调查了南非眼部保健服务的利用情况及其相关因素。
2011 年至 2012 年，招募了参加访谈和临床检查的年龄在 15 岁及以上的参与者参加 SANHANES。通过参与者对是否由医疗专业人员进行眼部检查以及上次检查的时间的回答来评估眼部保健服务的利用情况。使用多元逻辑回归模型，采用分层方法，依次纳入倾向因素（如年龄、性别）、促成因素（如健康保险）和需要因素（如高血压）进行数据分析。
本研究共抽取了 3320 名参与者，其中 64.9%为女性。73.4%（95%CI[69.7-76.7]）的参与者从未进行过眼部检查。经过统计学调整后，年龄组（与 15-29 岁相比：30-44 岁的优势比[OR]为 1.76；45-59 岁的 OR 为 2.13；60-74 岁的 OR 为 2.74；≥75 岁的 OR 为 3.22）、族裔（与非洲裔相比：白种人 OR 为 4.71；混血儿 OR 为 1.87；印度裔 OR 为 7.67）、高风险饮酒（OR 为 1.83）、财富指数（与最低五分位数相比：第三五分位数 OR 为 1.75；第四五分位数 OR 为 2.23；第五五分位数 OR 为 2.49）、健康保险（OR 为 2.19）、糖尿病（OR 为 1.75）、高胆固醇（OR 为 2.51）、过去 5 年内接受过医疗保健评估（OR 为 2.42）和自我报告的视力问题（OR 为 1.51）与眼部保健服务的利用显著相关。
近四分之三的南非被抽样者未利用眼部保健服务。加强当前的公共卫生措施（包括眼健康促进计划）以解决南非眼部保健服务利用率低和眼部保健服务利用差异的问题至关重要。
