title: Access to eye health services among indigenous Australians: an area level analysis.
abstract: BACKGROUND
  This project is a community-level study of equity of access to eye health services for Indigenous Australians.
  
  
  METHODS
  The project used data on eye health services from multiple sources including Medicare Australia, inpatient and outpatient data and the National Indigenous Eye Health Survey.The analysis focused on the extent to which access to eye health services varied at an area level according to the proportion of the population that was Indigenous (very low = 0-1.0%, low = 1.1-3.0%, low medium = 3.1-6.0%, high medium = 6.1-10.0%, high = 10.1-20.0%, very high = 20 + %). The analysis of health service utilisation also took into account age, remoteness and the Socioeconomic Indices for Areas (SEIFA).
  
  
  RESULTS
  The rate of eye exams provided in areas with very high Indigenous populations was two-thirds of the rate of eye exams for areas with very low indigenous populations. The cataract surgery rates in areas with high medium to very high Indigenous populations were less than half that reference areas. In over a third of communities with very high Indigenous populations the cataract surgery rate fell below the World Health Organization (WHO) guidelines compared to a cataract surgery rate of 3% in areas with very low Indigenous populations.
  
  
  CONCLUSIONS
  There remain serious disparities in access to eye health service in areas with high Indigenous populations. Addressing disparities requires a co-ordinated approach to improving Indigenous people's access to eye health services. More extensive take-up of existing Medicare provisions is an important step in this process. Along with improving access to health services, community education concerning the importance of eye health and the effectiveness of treatment might reduce reluctance to seek help.
authors.affiliation: Centre for Health Policy, Programs and Economics School of Population Health, Faculty of Medicine, Dentistry and Health Sciences University of Melbourne, 207 Bouverie st Parkville, Melbourne, 3010, Australia. mkelaher@unimelb.edu.au
authors.forename: Margaret
authors.initials: M
authors.lastname: Kelaher
authors.forename: Angeline
authors.initials: A
authors.lastname: Ferdinand
authors.forename: Hugh
authors.initials: H
authors.lastname: Taylor
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006303:Health Services, Indigenous / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D015995:Prevalence; D012030:Refractive Errors / Q000208:ethnology*; D015354:Vision, Low / Q000208:ethnology*; D055815:Young Adult