Rush University Medical College, Chicago, Illinois, USA.
Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Ophthalmic Epidemiol. 2023 Oct;30(5):537-539. doi: 10.1080/09286586.2022.2159985. Epub 2023 Jan 23.
Decreased public transit, no‑visitor policies, and other restrictions to reduce the spread of COVID‑19 may limit healthcare access for vision impaired adults. This study aimed to assess rates of healthcare delayed or forgone due to COVID‑19 among adults with low vision.
Data were analyzed from the 2021 National Health Interview Survey, a representative sample of US adults. Vision and hearing impairment were determined by self‑report. The primary study outcome was delayed or canceled medical care due to COVID‑19. Multivariable logistic regression models adjusted for gender, age, race, education, insurance, income, region, and chronic comorbidities were constructed to examine associations of medical care delayed due to COVID‑19.
Overall, 1.6% (n=457) of adults had vision impairment and 1.6% (n=438) had hearing impairment. Vision impairment was not associated with having taken a COVID‑19 test (P=0.34) or previous COVID‑19 infection (P=0.46). Adults with vs without low vision had higher rates of delayed (30.7% vs 19.2%, 1.86 [1.43-2.42], P<.0001) and cancelled care due to COVID-19 (23.9% vs 12.2%, 2.21 [1.66-2.94], P<.0001). Even compared to adults with hearing impairment, those with vision impairment were more likely to report canceled medical care due to COVID‑19 (1.20 [1.02-1.41], P=0.03).
Adults with low vision had increased risk of delayed and canceled medical care due to COVID‑19, with increased rates of canceled medical care even when compared to those with hearing impairment. These results suggest COVID‑19 and interventions to limit its spread have had a disproportionate impact on adults with low vision and place them at risk of poor health outcomes.
为了减少 COVID-19 的传播，减少公共交通、禁止访客等限制措施可能会限制视力障碍成年人的医疗保健机会。本研究旨在评估 COVID-19 对低视力成年人医疗保健的延迟或放弃率。
本研究分析了 2021 年全国健康访谈调查的数据，这是美国成年人的代表性样本。视力和听力障碍由自我报告确定。主要研究结果是由于 COVID-19 而延迟或取消的医疗护理。构建了多变量逻辑回归模型，以调整性别、年龄、种族、教育、保险、收入、地区和慢性合并症，以检查因 COVID-19 而延迟的医疗保健的关联。
总体而言，1.6%（n=457）的成年人有视力障碍，1.6%（n=438）有听力障碍。视力障碍与接受 COVID-19 检测（P=0.34）或以前的 COVID-19 感染（P=0.46）无关。与无低视力的成年人相比，低视力成年人因 COVID-19 而延迟（30.7% vs 19.2%，1.86 [1.43-2.42]，P<.0001）和取消护理的比率更高（23.9% vs 12.2%，2.21 [1.66-2.94]，P<.0001）。即使与听力障碍成年人相比，视力障碍成年人更有可能报告因 COVID-19 取消医疗护理（1.20 [1.02-1.41]，P=0.03）。
低视力成年人因 COVID-19 而延迟和取消医疗护理的风险增加，即使与听力障碍成年人相比，取消医疗护理的比率也更高。这些结果表明 COVID-19 及其限制传播的干预措施对低视力成年人产生了不成比例的影响，使他们面临不良健康结果的风险。
