Abstract
Purpose: To determine the association(s) between receiving an annual eye exam and various economic, social, and geographic factors assessed in the 2019 National Health Interview Survey (NHIS) among adults with diabetes. Patients and Methods: Data from adults 18 years of age and older relevant to self-reported non-gestational diabetes diagnosis and eye exam within the last 12 months were extracted from the 2019 NHIS dataset. A multivariate logistic regression model was used to determine associations between receiving an eye exam in the preceding 12 months and various economic, insurance-related, geographic, and social factors. Outcomes were reported as odds ratios (OR) with 95% confidence intervals (CI). Results: Among diabetic adults in the US, receiving an eye exam within the last 12 months was significantly associated with female sex (OR 1.29; 95% CI 1.05–1.58), residence in the Midwestern United States (OR 1.39; 95% CI 1.01–1.92), use of Veteran’s Health Administration healthcare (OR 2.15; 95% CI 1.34–3.44), having a usual place to go for healthcare (OR 3.89; 95% CI 2.16–7.01), and the use of Private, Medicare Advantage, or other insurance (OR 3.66; 95% CI 2.42–5.53), use of Medicare only excluding Medicare Advantage (OR 3.18; 95% CI 1.95–5.30), dual eligibility for Medicare and Medicaid (OR 3.88; 95% CI 2.21–6.79), and use of Medicaid and other public health insurance (OR 3.04; 95% CI 1.89–4.88) compared to those without insurance. An educational attainment of less than high school (OR 0.66; 95% CI 0.48–0.92), and an educational attainment of high school or GED without any college (OR 0.62; 95% CI 0.47–0.81) reduced the odds of having an annual eye exam. Conclusion: Economic, social, and geographic factors are associated with diabetic adults receiving an annual eye exam.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 613-621 |
| Number of pages | 9 |
| Journal | Clinical Ophthalmology |
| Volume | 17 |
| DOIs | |
| State | Published - 2023 |
Funding
The National Health Interview Survey (NHIS) is a large-scale household interview survey coordinated through the National Center of Health Statistics (NCHS) under the auspices of the Centers for Disease Control and Prevention (CDC) and was the primary source of information for this study. The survey has been conducted annually since 1957 and involves a statistically representative sample of the civilian non-institutionalized population of the United States. The main objective of the NHIS is to monitor the health of the US population through the collection and analysis of data on a broad range of health topics through household interviews. In 2019 the questionnaire structure was redesigned to improve the measurement of covered health topics, reduce respondent burden by shortening the length of the questionnaire, and better synergize with other federal health surveys.43 The NHIS is comprised of sample adult and sample child surveys which consist of four components: the annual core, rotating core, sponsored content (sustaining and periodic), and emerging topics. Annual core is content that is included in the NHIS every year. Rotating core is scheduled to appear on a periodic basis of every other year, one out of every three years, or two out of every three years. Sponsored content includes questions that are funded by other agencies and are included when funding is provided. Sustaining sponsors fund content every year, whereas other sponsors fund content periodically. Finally, emerging content is new content that is sponsored by NCHS on emerging topics. More information on the 2019 redesign of the NHIS can be found on the CDC website.43 Extensive documentation, questionnaires and code books are available on-line from the CDC.
Keywords
- diabetic retinopathy
- high deductible health plan
- insurance
- preventative health
- social determinants of health
- veteran
ASJC Scopus subject areas
- Ophthalmology
