Clinical Ophthalmology (Feb 2023)
Factors Associated with Annual Vision Screening in Diabetic Adults: Analysis of the 2019 National Health Interview Survey
Abstract
Alec Jotte,1 Willow Vander Kooi,2 Dustin D French1,3– 5 1Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; 2Northwestern University, Evanston, IL, USA; 3Departments of Ophthalmology and Medical Social Sciences, Northwestern University, Chicago, IL, USA; 4Center for Health Services and Outcomes Research, Northwestern University, Chicago, IL, USA; 5Veterans Affairs Health Services Research and Development Service, Chicago, IL, USACorrespondence: Dustin D French, 645 N. Michigan Ave., Suite 440, Chicago, IL, 60611, USA, Tel +1 312 503 5590, Fax +1 312 503 8152, Email [email protected]: To determine the association(s) between receiving an annual eye exam and various economic, social, and geographic factors assessed in the 2019 National Health Interview Survey (NHIS) among adults with diabetes.Patients and Methods: Data from adults 18 years of age and older relevant to self-reported non-gestational diabetes diagnosis and eye exam within the last 12 months were extracted from the 2019 NHIS dataset. A multivariate logistic regression model was used to determine associations between receiving an eye exam in the preceding 12 months and various economic, insurance-related, geographic, and social factors. Outcomes were reported as odds ratios (OR) with 95% confidence intervals (CI).Results: Among diabetic adults in the US, receiving an eye exam within the last 12 months was significantly associated with female sex (OR 1.29; 95% CI 1.05– 1.58), residence in the Midwestern United States (OR 1.39; 95% CI 1.01– 1.92), use of Veteran’s Health Administration healthcare (OR 2.15; 95% CI 1.34– 3.44), having a usual place to go for healthcare (OR 3.89; 95% CI 2.16– 7.01), and the use of Private, Medicare Advantage, or other insurance (OR 3.66; 95% CI 2.42– 5.53), use of Medicare only excluding Medicare Advantage (OR 3.18; 95% CI 1.95– 5.30), dual eligibility for Medicare and Medicaid (OR 3.88; 95% CI 2.21– 6.79), and use of Medicaid and other public health insurance (OR 3.04; 95% CI 1.89– 4.88) compared to those without insurance. An educational attainment of less than high school (OR 0.66; 95% CI 0.48– 0.92), and an educational attainment of high school or GED without any college (OR 0.62; 95% CI 0.47– 0.81) reduced the odds of having an annual eye exam.Conclusion: Economic, social, and geographic factors are associated with diabetic adults receiving an annual eye exam.Keywords: diabetic retinopathy, insurance, high deductible health plan, veteran, social determinants of health, preventative health
