Utilization of eye care providers by Canadian adolescents: evidence from the Canadian Community Health Survey.
OBJECTIVE
To examine whether different government-insured eye care coverage policies affect adolescents' access to eye care providers (ophthalmologists and optometrists) in Canada.


METHODS
Cross-sectional survey.


METHODS
11 015 Canadian adolescents aged 12 to 17 participated in the Canadian Community Health Survey (CCHS) 2007-2008.


METHODS
Self-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).


RESULTS
Across 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.


CONCLUSIONS
Lack of eye care insurance for routine eye examinations has a negative impact on adolescents' access to eye care providers in Canada.
Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ont.
Kunyong
K
Xu
Graham E
GE
Trope
Ray
R
Buncic
Ya-Ping
YP
Jin
D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D002170:Canada; D002648:Child; D003430:Cross-Sectional Studies; D003625:Data Collection; D004522:Educational Status; D005260:Female; D019538:Health Care Surveys; D006291:Health Policy; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income; D019458:Insurance Coverage; D008297:Male; D009885:Ophthalmology / Q000706:statistics & numerical data*; D009907:Optometry / Q000706:statistics & numerical data*