Eye care utilisation in Newfoundland and Labrador: access barriers and vision health outcomes

Lee, Elizabeth Y; Cui, Kangping; Trope, Graham E.; Buys, Yvonne M.; Chan, Christina H; Thavorn, Kednapa; Jin, Ya-Ping

doi:10.1016/j.jcjo.2017.11.012

Cited by 11 publications

(17 citation statements)

References 29 publications

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“…sociodemographic characteristics such as seniors population, low-income measures, and less education) (see Figure 1). [22,[26][27][28] The primary practice locations of optometrists in Canada were gathered from the provincial regulatory bodies. The Canadian Association of Optometrists (CAO) gathered primary practice information of optometrists for 2017 (i.e.…”

Section: Methodsmentioning

confidence: 99%

“…For example, in an analysis of the Canadian Longitudinal Study on Aging, Aljied, Aubin, Buhrmann[38] reported that older age and income are critical factors for visual impairment. A study in Newfoundland and Labrador also found that low socioeconomic status (including lack of government insurance) and living in non-urbanized areas are related to the under-utilization of eye care providers [26]. Ensuring adequate geographical distribution of health human resources and services is a key component of ensuring equitable access to health care [39].…”

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confidence: 99%

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Geographic Availability To Optometry Services Across Canada: Mapping Distribution, Need And Self-Reported Use

Shah

Milosavljevic

Bath

2020

Preprint

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Background: This research investigates the distribution of optometrists in Canada relative to population health needs and self-reported use of vision care services. Methods: Optometrist locations were gathered from provincial regulatory bodies. A geocoding approach converted descriptive data into geographic coordinates. Utilizationof vision care services was extracted from the Canadian Community Health Survey (CCHS) 2013-2014 question regarding self-reported contacts with optometrists or ophthalmologistsproviders. Data from the 2016 Statistics Canada census were used to create three population 'need' subgroups (65 years and over; low-income; and people aged 15 and over with less than a high school diploma). Optometrist-to-population ratios, expressed as number of providers per 10,000 people at the health region level, were then calculated.Three classes: low (< -1.5 standard deviation (SD); -1.5 to -0.50 SD), moderate (-0.5 to 0.5 SD), and high (0.50 to 1.5 SD, > 1.5 SD) were used as a cut-off for demonstrating distributionof optometrists across health regions). Cross-classification mapping compared optometrist distribution to self-reported use of vision care services in relation to need. Results: A total of 5,959 optometrists working across ten Canadian provinces were included in this analysis. The nationwide distribution of optometrists is variable across Canada and they are predominantly concentrated in urban areas. The mean ratio of optometrists across Canada was 1.70 optometrists per 10,000 people (range = 0.13 to 2.92). Out of 109 health regions (HRs), 26 were classified as low ratios, 51 HRs were classified as moderate ratios, and 32 HRs were high ratios. Thirty-five HRs were classified as low utilization, 39 HRs were classified as moderate, and 32 HRs as high utilization. HRs with a low optometrist ratio relative to eye care utilization and a high proportion of key sociodemographic characteristics (e.g. older age, low income) are located throughout Canada and identified with maps indicating areas of likely greater need for optometry services. Conclusion: This research provides a nationwide overview of vision care provided by optometrists identifying gaps in geographic availabilityrelative to "supply" and "need" factors. This examination of variation in accessibility to optometric services will be useful to inform workforce planning and policies.

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Geographic Availability To Optometry Services Across Canada: Mapping Distribution, Need And Self-Reported Use

Shah

Milosavljevic

Bath

2020

Preprint

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“…People regularly make decisions about when and why to seek health care. Studies in Canada, 19,21,26,27 the USA, 6,7,14 the UK, 13,20 India 18 and Saudi Arabia 28 identify influencers to seeking eye care among the general public or specific communities defined by age, race and/or socio-economic status. These studies have found that perceived motivators for seeking eye care include symptoms, prescription updates, failed screening, family history of eye disease, vision importance, and reduced eyecare costs, while perceived deterrents involve economic, logistical (time, family support, access), social stigma, symptom reliance, practitioner attributes (for example, gender) and other priorities.…”

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confidence: 99%

“…To date, Canadian studies of eye-care seeking behaviour have focused on specific communities such as older adults or the homeless. 21,26,27 Toward further understanding the public's knowledge of eye care in Canada, a qualitative study was conducted to help understand the Canadian context. Some of the findings of this larger study have been reported elsewhere.…”

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confidence: 99%

Motivators and deterrents for seeking eye care in a Canadian region

Spafford

Sivak

Lillakas

et al. 2020

Clinical and Experimental Optometry

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Background Motivators and deterrents for seeking eye care in a Canadian setting were sought using a qualitative study. Provincial deregulation of eyewear dispensing in 2010 allows consumers to order eyewear without an optical prescription, thus eliminating a potential motivator for obtaining an eye examination. Methods Convenience sampling was used to obtain 25 members of the public who contributed to one of seven focus groups that were facilitated, audiotaped, anonymised and transcribed. Participants completed a demographic questionnaire. Focus group data analysis employed grounded theory and theme saturation determined the number of focus groups. Results Nine men and 16 women participated, ranging in age from 18 to 71 years (mean 41.5; median 40.0). Three main themes were identified as influencers for seeking eye care: priority; advice; and capacity. Priority served as a motivator (‘lived experience’, ‘symptoms’, and ‘habit’) and deterrent (‘test distress’, ‘asymptomatic’, ‘don't know’ and ‘other priorities’). Advice was a motivator (‘professional’ and ‘family/friends’), while capacity was a motivator (‘insurance’) and deterrent (‘cost’). Conclusion The motivators and deterrents of seeking eye care in these focus groups were framed by three themes. Key findings not reported previously included the motivators of ‘habit’, ‘advice’ and ‘insurance’ and the potential deterrent of ‘test distress’. These factors should be added to other previously reported motivators and deterrents in further exploration of Canadian eye‐care seeking behaviours. Such knowledge is needed to develop strategies for improving eye‐care literacy in Canada. This is particularly important because eyewear deregulation and/or online eye examinations may encourage members of the public to bypass comprehensive eye care without fully understanding the implications of this decision for their health and wellness.

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“…In previous studies on eye care services/utilization, different socio-demographic characteristics have been found to be related to distribution of optometry services. A further analysis of the Canadian Longitudinal Study on Aging[24] identified disparities in the utilization of eye care services in Canada with less educated populations (less than bachelor's degree) and those with lower income less likely to use these services. For example, in an analysis of the Canadian Longitudinal Study on Aging, Aljied, Aubin, Buhrmann[23] reported that older age and income are critical factors for visual impairment.…”

mentioning

confidence: 99%

Geographic access to optometry services across Canada: Mapping distribution, need and self-reported use

Shah¹,

Milosavljevic²,

Bath³

2019

Preprint

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Background This research investigates the distribution of optometrists in Canada relative to population health needs and self-reported use of vision care services with a focus on identifying variation and poorly served health regions in order to gain a clearer understanding of geographic proximity of optometry services.Methods Optometrist locations were gathered from resources provided by provincial regulatory bodies. A geocoding approach then converted these descriptive data into a set of geographic coordinates. Utilization of vision care services was extracted from the Canadian Community Health Survey (CCHS) 2013-2014 question regarding self-reported contacts with vision care providers. Data from the 2016 Statistics Canada census were used to create three population 'need' subgroups (65 years and over; low-income; and people aged 15 and over with less than a high school diploma).Optometrist-to-population ratios, expressed as number of providers per 10,000 people at the health region level, were then calculated. Cross-classification mapping compared optometrist distribution to self-reported use of vision care services in relation to need.Results A total of 5,959 optometrists working across ten Canadian provinces were included in this analysis. The nationwide distribution of optometrists is variable across Canada and they are predominantly concentrated in densely populated urban areas. The mean ratio of optometrists across Canada was 1.70 optometrists per 10,000 people (range = 0.13 to 2.92). Out of 109 health regions (HRs), 26 were classified as low ratios, 51 HRs were classified as moderate ratios, and 32 HRs were high ratios. Thirty-five HRs were classified as low utilization, 39 HRs were classified as moderate, and 32 HRs as high utilization. HRs with a low optometrist ratio relative to eye care utilization and a high proportion of key sociodemographic characteristics are located throughout Canada and identified with maps indicating areas of likely greater need for optometry services.Conclusion This research provides a nationwide overview of vision care provided by optometrists identifying gaps in geographic access relative to "supply" and "need" factors. This in-depth examination of variation in population accessibility to optometric services will be useful to inform workforce planning and policies at national, provincial, and health region levels.

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Eye care utilisation in Newfoundland and Labrador: access barriers and vision health outcomes

Cited by 11 publications

References 29 publications

Geographic Availability To Optometry Services Across Canada: Mapping Distribution, Need And Self-Reported Use

Geographic Availability To Optometry Services Across Canada: Mapping Distribution, Need And Self-Reported Use

Motivators and deterrents for seeking eye care in a Canadian region

Geographic access to optometry services across Canada: Mapping distribution, need and self-reported use

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