Introduction: Diabetic retinopathy (a diabetes complication that affects eyes) is one of the leading causes of blindness and low vision in the US. More than 90% of vision loss caused by diabetes can be prevented by a routine annual eye examination and early treatment. However, data shows that about half of people with diabetes in the US do not receive the recommended annual eye screening exams, and there is a scarcity of literature assessing the specific role of health insurance. This study aimed to assess if having health insurance had an impact on eye screening. Methods: The nationally representative 2021 Behavioral Risk Factor Surveillance System (BRFSS) was used to examine having an eye exam within the past year among individuals 18 years of age and older who self-reported living with diabetes. Those who reported having some form of health insurance were considered as having access to health insurance and those who reported no, or don’t know or refused or missing responses were considered as having no access to insurance. Meeting the national recommendations of having a dilated eye exam within the past year was the primary outcome of interest. Those who reported having an eye exam within the past year were considered as meeting the recommendations and who reported no, or don’t know or more than one year ago were considered as not having the recommended service. Other independent variables were defined according to the Andersen Model of Healthcare Services Utilization (predisposing factors, enabling factors, need factors, environment, and health behavior. Chi-square analysis and multivariable logistic regression with OR and 95% CI were used to determine the association between eye screening and health insurance adjusting for other covariates. Results and conclusions: Ninety-one percent (91.3%, 53,919) of the adults reported having some form of health insurance, as compared to 8.7%(3,697) who reported having no form of insurance coverage. Approximately 66.2% of the study population had an eye exam at least once within the past year. A higher proportion of adults who had health insurance reported having an eye exam compared to those with no health insurance (68.6 vs. 44.8%; p=0.000). Among those older than 65 years, 73.9% had eye exam as compared to 42.7% among those younger than 35 years (p=$50,000, 71% had eye exam as compared to 59.9% in those earning
| Identifer | oai:union.ndltd.org:ETSU/oai:dc.etsu.edu:asrf-2091 |
| Date | 25 April 2023 |
| Creators | Toitole, Kusse, White, Melissa, Zheng, Shimin, Hale, Nathan |
| Publisher | Digital Commons @ East Tennessee State University |
| Source Sets | East Tennessee State University |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | Appalachian Student Research Forum |
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