title: Attributes associated with eye care use in the United States: a meta-analysis.
abstract: OBJECTIVE
  To model the factors that are associated with the use of eye care services among the US population with and without diabetes, stratifying by age group.
  
  
  METHODS
  Meta-analysis.
  
  
  METHODS
  We analyzed data from 3 datasets: the Behavioral Risk Factors Surveillance System combined years 2006-2009, the National Health and Nutrition Examination Survey combined years 2005-2008, and the National Health Interview Survey year 2008. For all 3 datasets, we analyzed data from all survey participants aged 40 years or older who participated in vision-related survey modules.
  
  
  METHODS
  We performed multivariate logistic regression analyses to assess associations between any eye care use within the previous year and 14 indicators of patient demographics and health. We estimated separate regressions for persons with and without diabetes stratified by age group. We combined estimates across datasets using a random effects model estimated using Markov Chain Monte Carlo algorithms.
  
  
  METHODS
  Use of eye care in the previous year and personal factors associated with eye care use.
  
  
  RESULTS
  Annual eye care use rates ranged from 46% to 51% in participants without diabetes and 64% to 72% in participants with diabetes. For people with and without diabetes, health insurance, an eye disease diagnosis, and higher income were associated with higher odds of eye care use. Being male was associated with lower odds of eye care use in some diabetes status and age group categories. Other variables, such as more education, being married, black race, Hispanic/Latino ethnicity, health status, heavy drinking, and limited ability to read small print, were associated with eye care use in only some diabetes status and age group categories.
  
  
  CONCLUSIONS
  Our findings indicate that economic and ocular health factors are associated with the greatest odds of annual eye care use. Access to health insurance and income levels greater than $35 000 US dollars (value at the time of interview) are associated with eye care use independently of other demographic factors.
authors.affiliation: Public Health Economics Program, RTI International, Atlanta, Georgia 30306, USA. wagner@rti.org
authors.forename: Laura Danielle
authors.initials: LD
authors.lastname: Wagner
authors.forename: David B
authors.initials: DB
authors.lastname: Rein
mesh_terms: D000328:Adult; D016208:Databases, Factual; D048909:Diabetes Complications / Q000453:epidemiology*; D004522:Educational Status; D005006:Ethnicity; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D007182:Income; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014786:Vision Disorders / Q000175:diagnosis*; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data*