Health Care Access and Use Among Adults With and Without Vision Impairment: Behavioral Risk Factor Surveillance System, 2018

Cheng, Qi; Okoro, Catherine A.; Méndez, Isabel; Lundeen, Elizabeth A.; Saaddine, Jinan B.; Stein, Roger B.; Holbrook, Joseph

doi:10.5888/pcd19.220066

Cited by 10 publications

(5 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The association of coverage gaps with unmet vision care needs was previously described in a pediatric population and may be explained by the need to find different clinicians who accept a new type of coverage, switching to plans with limited or no vision coverage, or contemporaneous social stressors (such as job loss) that disrupt access to care. As previously reported, US adults with a history of visual impairment are twice as likely to report medical costs as a barrier to vision care than adults without a visual impairment and are less likely to be covered by health insurance . Together with our data, these findings reveal the risk of a self-reinforcing cycle where socioeconomic disadvantage coincides with visual impairment and limits its effective treatment.…”

Section: Discussionsupporting

confidence: 87%

“…As previously reported, US adults with a history of visual impairment are twice as likely to report medical costs as a barrier to vision c are than adults without a visual impairment 2 and are less likely to be covered by health insurance. 8 Together with our data, these findings reveal the risk of a self-reinforcing cycle where socioeconomic disadvantage coincides with visual impairment and limits its effective treatment.…”

Section: Discussionsupporting

confidence: 75%

See 1 more Smart Citation

Association of Gaps in Health Insurance Coverage With Unmet Needs for Vision Care Among Adults in Ohio

2023

View full text Add to dashboard Cite

ImportanceAccess to vision care is vital to diagnose and treat vision impairment and diseases. Previous studies found that currently uninsured adults have limited access to vision care. It is unclear whether a recent history (past 12 months) of gaps in insurance coverage likewise adversely affects access to vision care.ObjectiveTo determine whether gaps in insurance coverage within the past 12 months are associated with higher risk of unmet needs for vision care among adults in Ohio.Design, Setting, and ParticipantsThis cross-sectional study analyzed data for adults in Ohio from the 2021 Ohio Medicaid Assessment Survey (OMAS), which is conducted via web, telephone, and mail. Participants were residents 19 years or older who reported needing vision care or eyeglasses within the past 12 months.ExposuresInsurance coverage over the past 12 months, classified as continuous private, continuous public, gap in coverage, or year-round uninsured.Main Outcomes and MeasureSelf-reported unmet need for vision care over the past 12 months.ResultsBased on a sample of 19 036 participants, we calculated that 4% of adults experienced recent coverage gaps (weighted total in the population, 180 259 of 4 518 841) while another 4% were year-round uninsured (187 552 adults). Unmet needs for vision care were reported by 13% (590 015 adults). On multivariable logistic regression, adults with gaps in coverage were at a higher risk of unmet vision care needs compared with adults who had continuous private coverage (odds ratio [OR], 2.9; 95% CI, 2.1-3.9; P &lt; .001) or continuous public coverage (OR, 1.7; 95% CI, 1.3-2.4; P = .001).Conclusions and RelevanceThis study found that gaps in health insurance coverage were associated with increased risk of unmet vision care needs among adults in Ohio compared with continuous private or public coverage. Policies that protect the continuity of health insurance coverage may help reduce the rate of unmet needs for vision care.

show abstract

Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 75%

Association of Gaps in Health Insurance Coverage With Unmet Needs for Vision Care Among Adults in Ohio

2023

View full text Add to dashboard Cite

show abstract

“…These results are aligned with the findings from a cross-sectional analysis of the 2018 Behavioral Risk Factor Surveillance System by Cheng et al, who also noted that adults with VI had lower access to health care compared with those without VI, specifically with a lower prevalence of having medical insurance coverage (81% vs 88%) and a higher prevalence of having an unmet health need due to cost (29% vs 13%). Although their study did not analyze the impact of VI on digital health technology and nonhealth use, their findings highlight how cost may significantly hinder accessibility in this population.…”

Section: Discussionmentioning

confidence: 99%

“…Access to digital technology is the first step in recognizing the potential inequalities that exist within telehealth between older adults with and without VI. Previous literature on VI and access to digital technology has been limited; instead, studies have focused on other consequences of VI, such as health care access 14 or tasks of everyday life. 15 Thus, the aim of this study was to identify discrepancies in digital technology access for older adults with VI compared with peers without VI using national data.…”

mentioning

confidence: 99%

Digital Technology Use Among Older Adults With Vision Impairment

Thomas,

Almidani,

Swenor

et al. 2024

JAMA Ophthalmol

View full text Add to dashboard Cite

ImportanceTelehealth has the potential to improve health for older adults, but many access disparities exist, including for those with vision impairment (VI).ObjectiveTo examine the associations between VI and digital technology access measures in US older adults.Design, Setting, and ParticipantsThis was a cross-sectional study that included Medicare beneficiaries 65 years and older. Beneficiary data were obtained from the National Health and Aging Trends Study (NHATS) 2021; data collection was conducted from June 2020 through January 2021. Data were analyzed September 2023.ExposureVI, measured on categorical (distance and near VI [&gt;0.30 logMAR], contrast sensitivity impairment [CSI; &lt;1.55 logCS], and any VI [distance VI, near VI, or CSI]), and continuous (distance and near acuity [logMAR] and contrast sensitivity [logCS]) scales.Main OutcomesSelf-reported outcomes of digital technology access from the technological environment component of the NHATS.ResultsOf the 2822 Medicare beneficiaries (mean [SD] age, 78.5 [5.6] years; 1605 female [54.7%]) included in this study, patients self-identified with the following race and ethnicity categories (weighted percentages): 575 non-Hispanic Black (8.0%), 132 Hispanic (7.0%), 2019 non-Hispanic White (81.7%), and 63 non-Hispanic other race (3.4%), which included American Indian, Alaska Native, Asian, multiracial, Native Hawaiian, Pacific Islander, or other specified race. A total of 1077 of 2822 patients (32.3%) had any VI. In multivariable logistic regression models, older adults with any VI had lower odds of having or knowing how to use a cellphone (odds ratio [OR], 0.58; 95% CI, 0.38-0.88), computer (OR, 0.61; 95% CI, 0.47-0.79), or tablet (OR, 0.68, 95% CI = 0.54-0.85) than peers without VI. In other models, near VI was associated with lower odds of having and knowing how to use a phone (OR, 0.56; 95% CI, 0.36-0.87), computer (OR, 0.57; 95% CI, 0.44-0.75), or tablet (OR, 0.65; 95% CI, 0.52-0.81) compared with no near VI. CSI was associated with lower odds of having and knowing how to use a phone (OR, 0.66; 95% CI, 0.45-0.99) or computer (OR, 0.72; 95% CI, 0.55-0.93) compared with no CSI. Distance VI was only associated with lower odds of having and knowing how to use a cellphone (OR, 0.63; 95% CI, 0.41-0.95). Any VI and individual categorical VI measures were not associated with other outcomes of digital health– and nonhealth-related experiences. Similar associations were noted when vision was examined on a continuous scale. However, worse distance acuity (per 0.1 logMAR) was associated with being less likely to visit with family or friends on a video call (OR, 0.91; 95% CI, 0.84-0.98) and to order or refill prescriptions online (OR, 0.90; 95% CI, 0.83-0.97).Conclusions and RelevanceResults suggest that older US adults with VI were less likely to have access to digital technology than peers without VI, although no differences were noted in the report of digital health– and nonhealth-related activities. These findings highlight the potential for inequities that may arise in telehealth for older adults with VI and the necessity to develop strategies to improve accessibility of telemedicine for all.

show abstract

“…Previous studies have confirmed that VI, combined with chronic conditions, influences patients’ health status and quality of life significantly more than one condition alone [ 9 , 50 ]. Additionally, studies have suggested that patients with VI have less access to healthcare than those without VI [ 51 , 52 ]. Therefore, for patients who have both VI and systemic conditions, especially multimorbidity, clinicians should pay more attention to their healthcare services to improve their physical status.…”

Section: Discussionmentioning

confidence: 99%

Associations between vision impairment and multimorbidity among older Chinese adults: results from the China health and retirement longitudinal study

Xiong,

Mao,

Zhang

et al. 2023

BMC Geriatr

View full text Add to dashboard Cite

Background Although several studies have reported the relationship between vision impairment (VI) and multimorbidity in high-income countries, this relationship has not been reported in low- and middle-income countries. This study aimed to explore the relationship between VI with multimorbidity and chronic conditions among the elderly Chinese population. Methods The cross-sectional analysis was applied to data from the China Health and Retirement Longitudinal Study (CHARLS) in 2018. A total of 8,108 participants ≥ 60 years old were included, and 15 chronic conditions were used in this study. Logistic regression analysis was used to analyze the relationship between VI with multimorbidity and chronic conditions. Results The prevalence of 15 chronic conditions and multimorbidity was higher among the elderly with VI than those without VI. After adjusting for demographic and socioeconomic confounders, 10 chronic conditions were associated with VI (all P < 0.05). Furthermore, positive association was observed between VI and one (odds ratio [OR]: 1.52; 95% confidence intervals [95%CI]: 1.16–2.00; P = 0.002), two (OR: 2.09; 95%CI: 1.61–2.71; P < 0.001), three (OR: 2.87; 95%CI: 2.22–3.72; P < 0.001), four (OR: 3.60; 95%CI: 2.77–4.69; P < 0.001), and five or more (OR: 5.53; 95%CI: 4.32–7.09; P < 0.001) chronic conditions, and the association increased as the number of chronic conditions (P for trend < 0.001). Sensitivity analysis stratified by gender, education, smoking status, and annual per capita household expenditure still found VI to be positively associated with multimorbidity. Conclusions For patients older than 60 years, VI was independently associated with multimorbidity and various chronic conditions. This result has important implications for healthcare resource plans and clinical practice, for example, increased diabetes and kidney function screening for patients with VI.

show abstract

Health Care Access and Use Among Adults With and Without Vision Impairment: Behavioral Risk Factor Surveillance System, 2018

Cited by 10 publications

References 25 publications

Association of Gaps in Health Insurance Coverage With Unmet Needs for Vision Care Among Adults in Ohio

Association of Gaps in Health Insurance Coverage With Unmet Needs for Vision Care Among Adults in Ohio

Digital Technology Use Among Older Adults With Vision Impairment

Associations between vision impairment and multimorbidity among older Chinese adults: results from the China health and retirement longitudinal study

Contact Info

Product

Resources

About