Utilization of eye care providers by Canadian adolescents: evidence from the Canadian Community Health Survey

Abstract

ObjectiveTo examine whether different government-insured eye care coverage policies affect adolescents' access to eye care providers (ophthalmologists and optometrists) in Canada. DesignCross-sectional survey. Participants11 015 Canadian adolescents aged 12 to 17 participated in the Canadian Community Health Survey (CCHS) 2007-2008. MethodsSelf-reported use of eye care providers, was compared between adolescents with and without government-insured routine eye examinations. The association between the utilization and the government coverage was evaluated by using prevalence ratios (PR) and 95% confidence intervals (CI). ResultsAcross Canada, 45.6% of adolescents used eye care providers over a 12-month period. The utilization rate was highest (46.4%) in provinces with insured routine eye examinations, lower (35.9%) in provinces without insured routine eye examinations, and lowest (27.1%) in the 3 territories. Significantly lower utilization rates were also found in males (10% less likely than females); in those without dwelling ownership (19% less likely than those who owned); in those who read fewer than 3 hours weekly (13% less likely than in those who read 3 or more hours per week); and in nondiabetics. After adjusting for the confounding effects of these factors, we found that adolescents living in provinces with uninsured routine eye examinations were 24% less likely to utilize eye care services (PR = 0.76; 95% CI 0.67-0.85); whereas those in the 3 territories were nearly 40% less likely to use eye care providers (PR = 0.63; 95% CI 0.48-0.83) compared to adolescents in provinces with insured routine eye examinations. ConclusionsLack of eye care insurance for routine eye examinations has a negative impact on adolescents' access to eye care providers in Canada.