与眼科保健障碍相关的特征：在一次免费视力筛查活动中的横断面调查。
Characteristics Associated with Barriers to Eye Care: A Cross-Sectional Survey at a Free Vision Screening Event.
机构信息
Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA,
出版信息
Ophthalmic Res. 2023;66(1):170-178. doi: 10.1159/000526875. Epub 2022 Sep 5.
INTRODUCTION
Social determinants of health can limit access to regular eye care, but their role in ophthalmology is underexamined. The purpose of this study is to assess the relationship between patient characteristics and self-reported barriers to eye care.
METHODS
This anonymous, cross-sectional survey was conducted at a 2-day free eye clinic event in Pittsburgh, Pennsylvania. Adult patients presenting for vision screening were eligible to participate. Patient characteristics (demographics, health status) and self-reported barriers to eye care were collected. Predictors of barriers to eye care were analyzed using binary logistic regression.
RESULTS
Of 269 eligible, consecutive patients approached for survey completion, 183 comprised the volunteer sample. The 183 participants (105 female patients [59%]) had a mean (standard deviation) age of 53 (15) years and generally self-identified as Black (74, 46%) or White (67, 41%). While a third reported having no health insurance (60, 34%), the remaining two-thirds of participants had public (84, 48%) or private coverage (34, 19%). Three-quarters of respondents reported at least one barrier to receiving regular eye care (136, 76%), most commonly medical costs (89, 50%) and insurance issues (73, 41%). Not having health insurance or vision insurance was strongly associated with reporting at least one barrier to care (OR: 5.00, p = 0.002, and OR: 7.46, p < 0.001, respectively). Those with self-reported eye disease were more likely to report transportation difficulties (OR: 4.45, p = 0.013), and employed participants reported difficulty getting time off work to attend eye exams (OR: 7.73, p = 0.002). Finally, compared to Black race, White race was associated with a higher likelihood of reporting any barrier to care (OR: 2.79, p = 0.013).
CONCLUSION
Three-quarters of vision screening attendees reported at least one barrier to regular eye care, most commonly medical costs and insurance.
简介
健康的社会决定因素可能会限制人们获得定期的眼部护理，但它们在眼科领域的作用尚未得到充分研究。本研究旨在评估患者特征与自我报告的眼部护理障碍之间的关系。
方法
这项匿名的横断面调查是在宾夕法尼亚州匹兹堡市为期两天的免费眼科诊所活动中进行的。参加视力筛查的成年患者符合入组条件。收集了患者特征（人口统计学、健康状况）和自我报告的眼部护理障碍。使用二项逻辑回归分析预测眼部护理障碍的因素。
结果
在 269 名符合条件的连续患者中，有 183 名患者接受了调查。183 名参与者（105 名女性患者[59%]）的平均（标准差）年龄为 53（15）岁，通常自认为是黑人（74 名，46%）或白人（67 名，41%）。虽然三分之一的人报告没有医疗保险（60 名，34%），但其余三分之二的参与者有公共保险（84 名，48%）或私人保险（34 名，19%）。76%（136 名）的受访者报告至少有一个接受定期眼部护理的障碍，最常见的是医疗费用（89 名，50%）和保险问题（73 名，41%）。没有医疗保险或视力保险与报告至少有一个护理障碍密切相关（OR：5.00，p = 0.002，和 OR：7.46，p < 0.001）。自我报告有眼部疾病的人更有可能报告交通困难（OR：4.45，p = 0.013），而有工作的参与者报告说很难请假去做眼部检查（OR：7.73，p = 0.002）。最后，与黑人种族相比，白人种族更有可能报告任何眼部护理障碍（OR：2.79，p = 0.013）。
结论
四分之三的视力筛查参与者报告至少有一个定期眼部护理障碍，最常见的是医疗费用和保险。
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