Kaur Jeeventh, Im James, Buys Yvonne, Trope Graham, Ngo Gordon, Nichani Prem A H, Jin Ya-Ping
Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Can J Ophthalmol. 2025 Jun;60(3):e350-e356. doi: 10.1016/j.jcjo.2024.08.005. Epub 2024 Aug 22.
To obtain prescription eyewear in Ontario, eye exams must be performed by optometrists or ophthalmologists (eye care providers [ECPs]). In 2004, government-insured routine eye exams were delisted for Ontarians aged 20-64 leaving eye exam coverage only for those aged ≤19 and 65+. We assessed whether having eyewear insurance impacts Ontarians' utilization of ECPs.
Cross-sectional survey.
Ontarians aged 12+ without diabetes responding to the Canadian Community Health Survey in 2003, 2005, and 2013/2014.
We compared the utilization of ECPs by eyewear insurance status and eligibility for government-funded eye exams. Individuals with eyewear insurance funded by employers, government or privately were considered to have insurance.
ECP utilization was significantly higher in Ontarians with eyewear insurance versus those without, in all survey years and all age groups, including those eligible for government-funded eye exams (e.g., 66.4% vs 59.1% [p < 0.05] for the 65+). This higher level of utilization was particularly evident among Ontarians aged 20-64 in 2013/2014, when this group no longer had government-funded eye exams (34.9% vs 19.9% among 20-39-year-olds, 43.4% vs 32.9% among 40-64-year-olds, p < 0.05 for both). Adjusting for confounding effects, the likelihood of visiting an ECP was greater among Ontarians with eyewear insurance than those without (adjusted prevalence ratio 1.26 for Ontarians aged 12+ and 1.41 for those aged 20-64; p < 0.05 for both).
Lack of eyewear insurance negatively impacts the utilization of ECPs, even among Ontarians eligible for government-funded eye exams, where the cost barrier for eye exams has been removed by the Ontario government.
在安大略省获取处方眼镜，必须由验光师或眼科医生（眼保健提供者[ECPs]）进行眼部检查。2004年，面向20至64岁安大略居民的政府承保常规眼部检查被取消，仅保留了对19岁及以下和65岁及以上人群的眼部检查覆盖范围。我们评估了拥有眼镜保险是否会影响安大略居民对眼保健提供者的利用情况。
横断面调查。
2003年、2005年以及2013/2014年对加拿大社区健康调查做出回应的12岁及以上无糖尿病的安大略居民。
我们根据眼镜保险状况和政府资助眼部检查的资格，比较了眼保健提供者的利用情况。由雇主、政府或私人资助的拥有眼镜保险的个体被视为有保险。
在所有调查年份和所有年龄组中，包括那些有资格获得政府资助眼部检查的人群，有眼镜保险的安大略居民对眼保健提供者的利用率显著高于没有保险的居民（例如，65岁及以上人群中分别为66.4%对59.1%[p<0.05]）。这种较高的利用率在2013/2014年20至64岁的安大略居民中尤为明显，当时该年龄组不再享有政府资助的眼部检查（20至39岁人群中分别为34.9%对19.9%，40至64岁人群中分别为43.4%对32.9%，两者p均<0.05）。在调整混杂效应后，有眼镜保险的安大略居民比没有保险的居民看眼保健提供者的可能性更大（12岁及以上安大略居民的调整患病率比为1.26，20至64岁居民为1.41；两者p均<0.05）。
缺乏眼镜保险对眼保健提供者的利用产生负面影响，即使在安大略那些有资格获得政府资助眼部检查的居民中也是如此，而在安大略，政府已消除了眼部检查的费用障碍。
