Improving Access to Eye Care

Solomon, Sharon D.; Shoge, Ruth Y.; Ervin, Ann Margret; Contreras, Melissa; Harewood, Joy; Aguwa, Ugochi T.; Olivier, Mildred M.G.

doi:10.1016/j.ophtha.2022.07.012

Cited by 40 publications

(21 citation statements)

References 161 publications

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“…In the United States, access to vision care is shaped by demographic characteristics such as race and ethnicity, geographical region, existing disability, and educational attainment. 6 Access to vision care is particularly limited by financial barriers, including uninsurance and underinsurance. Previous research has described differences in access to vision care based on current insurance coverage.…”

Section: Discussionmentioning

confidence: 99%

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

2023

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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.

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Section: Discussionmentioning

confidence: 99%

“…5 In contrast, the US population comprises 1.3% American Indian and Alaska Native residents, 6.1% Asian residents, 13.6% Black and African American residents, 18.9% Hispanic and Latino residents, and 58.3% non-Hispanic White residents. 6 The discrepancy in the racial and ethnic makeup Related article page 488…”

Section: Discussionmentioning

confidence: 99%

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

2023

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“…While previous reviews exist, none have delved into this subject on such a comprehensive scale, instead focusing on one aspect, such as racial and ethnic disparities 6,7 or interventions to improve access to care. [8][9][10] Moreover, there has been a surge of recent research focused on the topic, accompanied by the introduction of interventions leveraging new technology, including developments in the use of telemedicine and artificial intelligence. 11,12 This narrative review considers the disparities in glaucoma severity, treatment modalities, medication/surgical access, and novel interventions across various countries.…”

Section: Introductionmentioning

confidence: 99%

“…The exploration of the social determinants of health and their impact on glaucoma represents a crucial yet overlooked area in research. While previous reviews exist, none have delved into this subject on such a comprehensive scale, instead focusing on one aspect, such as racial and ethnic disparities 6,7 or interventions to improve access to care 8–10 . Moreover, there has been a surge of recent research focused on the topic, accompanied by the introduction of interventions leveraging new technology, including developments in the use of telemedicine and artificial intelligence 11,12 .…”

Section: Introductionmentioning

confidence: 99%

Social determinants of health and health disparities in glaucoma: A review

Acuff,

Wu,

Varkhedi

et al. 2024

Clinical Exper Ophthalmology

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Social determinants of health and barriers to care can significantly impact patients' access to glaucoma care and treatment, resulting in disparities within disease presentation, progression, management, and treatment outcomes. The widespread adoption of electronic health record systems has allowed researchers and clinicians to further explore these relationships, identifying factors such as race, ethnicity, and socioeconomic status to be risk factors for more severe disease and lower treatment adherence. These disparities highlight potential targets for interventions to combat these disparities and improve overall patient outcomes. This article provides a summary of the available data on health disparities within glaucoma disease presentation, progression, management, treatment, and outcomes and discusses interventions to improve care delivery and outcomes among patients with glaucoma.

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“…2 Identifying corneal diseases can be challenging and time-consuming, particularly when access to a specialized eye care provider is limited. 3,4 Accurate and timely diagnosis of these conditions is paramount to preserving visual acuity and ensuring optimal patient outcomes.…”

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confidence: 99%

Performance of ChatGPT in Diagnosis of Corneal Eye Diseases

Delsoz,

Madadi,

Raja

et al. 2024

Cornea

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Purpose: The aim of this study was to assess the capabilities of ChatGPT-4.0 and ChatGPT-3.5 for diagnosing corneal eye diseases based on case reports and compare with human experts. Methods: We randomly selected 20 cases of corneal diseases including corneal infections, dystrophies, and degenerations from a publicly accessible online database from the University of Iowa. We then input the text of each case description into ChatGPT-4.0 and ChatGPT-3.5 and asked for a provisional diagnosis. We finally evaluated the responses based on the correct diagnoses, compared them with the diagnoses made by 3 corneal specialists (human experts), and evaluated interobserver agreements. Results: The provisional diagnosis accuracy based on ChatGPT-4.0 was 85% (17 correct of 20 cases), whereas the accuracy of ChatGPT-3.5 was 60% (12 correct cases of 20). The accuracy of 3 corneal specialists compared with ChatGPT-4.0 and ChatGPT-3.5 was 100% (20 cases, P = 0.23, P = 0.0033), 90% (18 cases, P = 0.99, P = 0.6), and 90% (18 cases, P = 0.99, P = 0.6), respectively. The interobserver agreement between ChatGPT-4.0 and ChatGPT-3.5 was 65% (13 cases), whereas the interobserver agreement between ChatGPT-4.0 and 3 corneal specialists was 85% (17 cases), 80% (16 cases), and 75% (15 cases), respectively. However, the interobserver agreement between ChatGPT-3.5 and each of 3 corneal specialists was 60% (12 cases). Conclusions: The accuracy of ChatGPT-4.0 in diagnosing patients with various corneal conditions was markedly improved than ChatGPT-3.5 and promising for potential clinical integration. A balanced approach that combines artificial intelligence–generated insights with clinical expertise holds a key role for unveiling its full potential in eye care.

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Improving Access to Eye Care

Cited by 40 publications

References 161 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

Social determinants of health and health disparities in glaucoma: A review

Performance of ChatGPT in Diagnosis of Corneal Eye Diseases

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