title: Measuring socioeconomic inequalities in eye care services among patients with diabetes in Alberta, Canada, 1995-2009.
abstract: OBJECTIVE
  Diabetic retinopathy (DR) is a leading cause of blindness in Canada. Despite established comprehensive guidelines for routine DR screening, the rate of provision of diabetic eye care services by ophthalmologists in Alberta decreased in past years. The aim of this study was to examine socioeconomic status (SES)-related inequalities in the use of eye care services for patients with diabetes in Alberta, Canada.
  
  
  METHODS
  We used data from the Alberta Diabetes Surveillance System (ADSS), including visits to ophthalmologists over a 15-year period (1995-2009). Socioeconomic inequalities in the use of eye care services were assessed using the Relative Concentration Index (RCI). We used three different SES indicators: median household income and the Canadian material and social deprivation indices (MDI and SDI).
  
  
  RESULTS
  Socioeconomic inequalities in use of eye care services exist in patients with diabetes, although the magnitudes of the inequalities were small and steadily decreased over time; income- and MDI-related RCI indicated that individuals with greater income or less material deprivation were more likely to use eye care services. However, for SDI-related RCI, socially deprived individuals were more likely to use eye care services (RCI: 1995: -0.066; 2002: -0.036; 2009: -0.028).
  
  
  CONCLUSIONS
  Our findings suggest a need for attention to the potential impact of provincial policy on inequalities in eye care services among patients with diabetes, particularly as it relates to geographical differences across regional health zones.
authors.affiliation: Department of Health Promotion, Daegu University, 201 Daegudae-ro, Gyeongsan, Gyeongbuk 38453, Republic of Korea.
authors.forename: Jongnam
authors.initials: J
authors.lastname: Hwang
authors.affiliation: Department of Ophthalmology and Visual Sciences, Faculty of Medicine and Dentistry, University of Alberta, 10240 Kingsway Avenue NW, Edmonton, Alberta T5H 3V9, Canada.
authors.forename: Christopher
authors.initials: C
authors.lastname: Rudnisky
authors.affiliation: School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, 451 Smyth Road, Roger-Guindon Building, Ottawa, Ontario K1H 8M5, Canada.
authors.forename: Sarah
authors.initials: S
authors.lastname: Bowen
authors.affiliation: School of Public Health, University of Alberta, 11405 87 Avenue, Edmonton, Alberta T6G 1C9, Canada. Electronic address: jeff.johnson@ualberta.ca.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000416:Alberta; D002170:Canada; D003930:Diabetic Retinopathy / Q000453:epidemiology*; D005260:Female; D054625:Healthcare Disparities; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008297:Male; D012923:Social Class; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Concentration index; Diabetic retinopathy; Eye screening services; Socioeconomic inequalities