title: Eye care use among a high-risk diabetic population seen in a public hospital's clinics.
abstract: OBJECTIVE
  Little is known regarding eye care use among low-income persons with diabetes mellitus, especially African Americans.
  
  
  OBJECTIVE
  To investigate eye care use among patients with diabetes who were seen in a county hospital clinic that primarily serves high-risk, low-income, non-Hispanic African American patients.
  
  
  METHODS
  A retrospective cohort study with 2 years of follow-up examined eye care use among adult patients with diabetes seen in 2007 in an outpatient medical clinic of a large, urban county hospital that primarily serves low-income, non-Hispanic African American patients. Patients with a history of retinopathy and macular edema or a current diagnosis indicating ophthalmic complications were excluded. Eye care use was defined dichotomously as whether or not patients had a visit to the eye clinic for any eye care examination or procedure. We estimated crude and adjusted rate ratios (aRRs) and 95% CIs for the association between eye care use and selected clinical and demographic characteristics.
  
  
  RESULTS
  There were 867 patients with diabetes identified: 61.9% were women, 76.2% were non-Hispanic African American, and 61.4% were indigent, with a mean age of 51.8 years. Eye care utilization rates were 33.2% within 1 and 45.0% within 2 years. For patients aged 19 to 39 years compared with those aged 65 years or older, significantly decreased eye care utilization rates were observed within 1 year (aRR, 0.48; 95% CI, 0.27-0.84) and within 2 years (aRR, 0.61; 95% CI, 0.38-0.99).
  
  
  CONCLUSIONS
  Overall eye care utilization rates were low. Additional education efforts to increase the perception of need among urban minority populations may be enhanced if focused on younger persons with diabetes.
authors: Department of Surgery, School of Medicine, University of Alabama at Birmingham.
authors: Paul A
authors: PA
authors: Maclennan
authors: Department of Surgery, School of Medicine, University of Alabama at Birmingham2Department of Epidemiology, School of Public Health, University of Alabama at Birmingham3Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham.
authors: Gerald
authors: G
authors: McGwin
authors: Jefferson County Health System, Cooper Green Mercy Hospital, Birmingham, Alabama.
authors: Christine
authors: C
authors: Heckemeyer
authors: Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham.
authors: Virginia R
authors: VR
authors: Lolley
authors: Jefferson County Health System, Cooper Green Mercy Hospital, Birmingham, Alabama.
authors: Sandral
authors: S
authors: Hullett
authors: Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: Jinan
authors: J
authors: Saaddine
authors: Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: Sundar S
authors: SS
authors: Shrestha
authors: Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham.
authors: Cynthia
authors: C
authors: Owsley
mesh_terms: D000328:Adult; D001741:Black or African American / Q000208:ethnology; D000368:Aged; D000369:Aged, 80 and over; D000407:Alabama / Q000453:epidemiology; D001766:Blindness / Q000208:ethnology / Q000517:prevention & control; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000208:ethnology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000208:ethnology; D003930:Diabetic Retinopathy / Q000175:diagnosis* / Q000208:ethnology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006296:Health Services / Q000706:statistics & numerical data*; D006302:Health Services Research; D006779:Hospitals, Public / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D015354:Vision, Low / Q000208:ethnology / Q000517:prevention & control; D044465:White People / Q000208:ethnology; D055815:Young Adult