Asare Afua O, Horns Joshua J, Stagg Brian C, Richards-Steed Rebecca, Young Marielle, Watt Melissa H, Stipelman Carole, Del Fiol Guilherme, Hartmann E Eugenie, Keenan Heather T, Asare Elliot A, Smith J D
John A. Moran Eye Center, Department of Ophthalmology & Visual Sciences, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, Utah; Department of Population Health Sciences, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, Utah.
Department of Surgery, Huntsman Cancer Institute, Salt Lake City, Utah.
J AAPOS. 2024 Dec;28(6):104054. doi: 10.1016/j.jaapos.2024.104054. Epub 2024 Nov 16.
The American Academy of Pediatrics recommends pediatric vision screening to detect and refer vision disorders during the critical early years when intervention yields the greatest benefits. We determined the rate of vision screening for US children 3-5 years of age with commercial insurance and compared rates among those living in rural versus urban areas. Children in rural compared with urban areas were expected to have lower rates of vision screening.
A cross-sectional study using commercial claims for 3- to 5-year-olds derived from the Merative MarketScan Database (IBM, Armonk, NY), 2011-2020, was conducted. Primary outcome was the proportion of children with a claim for vision screening. Adjusted incident rate ratios (aIRR) of vision screening with 95% confidence intervals were computed for children living in rural compared with urban areas of the United States.
Claims for 2,299,631 children were included. Most children (1,724,923 [75.0%]) were enrolled in preferred provider organization plans and lived in urban areas (2,031,473 [88.3%]). A total of 662,619 (28.8%) had a claim for a vision screening. Children living in rural versus urban areas had a lower adjusted incident rate of vision screening (15.1 vs 30.6%, aIRR 0.57; 95% CI, 0.53- 0.61) after adjusting for sex, age, region, and insurance type.
For preschool age children with commercial insurance, vision screening is low, especially in rural compared with urban areas.
美国儿科学会建议进行儿科视力筛查，以便在干预能带来最大益处的关键早期阶段发现并转诊视力障碍患者。我们确定了参加商业保险的美国3至5岁儿童的视力筛查率，并比较了农村和城市地区儿童的筛查率。预计农村地区儿童的视力筛查率低于城市地区。
利用2011年至2020年从艾美仕市场调研数据库（IBM，纽约州阿蒙克）获取的3至5岁儿童商业保险理赔数据进行了一项横断面研究。主要结局是有视力筛查理赔记录的儿童比例。计算了美国农村和城市地区儿童视力筛查的调整发病率比（aIRR）及其95%置信区间。
纳入了2,299,631名儿童的理赔数据。大多数儿童（1,724,923名[75.0%]）参加了优选提供者组织计划，且居住在城市地区（2,031,473名[88.3%]）。共有662,619名（28.8%）有视力筛查理赔记录。在对性别、年龄、地区和保险类型进行调整后，农村地区儿童的视力筛查调整发病率低于城市地区（15.1%对30.6%，aIRR 0.57；95%CI，0.53 - 0.61）。
对于参加商业保险的学龄前儿童，视力筛查率较低，尤其是农村地区低于城市地区。
