Socioeconomic factors associated with visual impairment and ophthalmic care utilization in patients with type II diabetes

Abstract

Objective: To examine the association between socioeconomic factors and ophthalmic care services/visual impairment among patients with diabetes.

Design: Data from the Survey on Living with Chronic Disease in Canada (SLCDC)-Diabetes Component 2011 were used.

Participants: A cross-sectional, nationally representative sample of patients with diabetes weighted to represent the civilian, noninstitutionalized Canadian population with self-reported type II diabetes.

Methods: Socioeconomic factors were classified into predictive factors, need, and non-need factors. Factors associated with the ophthalmic care utilization and visual impairment were assessed using logistic regression models, weighted for the SLCDC sampling strategy.

Results: Among all patients with type II diabetes, factors associated with increased eye screening were: (i) discussion of diabetic complications with health professionals (odds ratio [OR] 2.02, 95% CI 1.28-3.19); (ii) having private insurance (OR 3.23, 95% CI 2.21-4.73); and (iii) duration of diabetes longer than 10 years (OR 1.53, 95% CI 1.04-2.25). Among asymptomatic patients (those who reported having no visual impairment), patients with lower income had 40% decreased odds of having eye screening services compared with those with higher income (OR 0.60, 95% CI 0.37-0.98). Among all patients with type II diabetes, visual impairment was more likely in females (OR 1.53, 95% CI 1.12-2.09), older patients (OR 18.12, 95% CI 6.63-49.51), and those with poor self-rated health (OR 3.10, 95% CI 1.62-5.96).

Conclusions: Our study found that interactions between health professionals and patients, as well as having private health insurance, were the main factors associated with ophthalmic resource utilization, whereas age, sex, duration of diabetes, and self-rated health were associated with visual impairment in patients with type II diabetes.