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Factors Associated With Ocular Health Care Utilization Among Hispanics/Latinos: Results From an Ancillary Study to the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

TitleFactors Associated With Ocular Health Care Utilization Among Hispanics/Latinos: Results From an Ancillary Study to the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).
Publication TypePublication
Year2016
AuthorsMcClure LA, D Zheng D, Lam BL, Tannenbaum SL, Joslin CE, Davis S, López-Cevallos D, Youngblood ME, Zhang Z-M, Chambers CPulido, Lee DJ
JournalJAMA Ophthalmol
Volume134
Issue3
Pagination320-9
Date Published2016 Mar
ISSN2168-6173
KeywordsAdult, Central America, Cohort Studies, Cuba, Eye Diseases, Female, Health Services Accessibility, Health Services Research, Health Surveys, Hispanic Americans, Humans, Male, Middle Aged, Odds Ratio, Patient Acceptance of Health Care, Risk Factors, South America, Vision Tests
Abstract

IMPORTANCE: Regular ocular care is critical to early detection and prevention of eye disease and associated morbidity and mortality; however, there have been relatively few studies of ocular health care utilization among Hispanics/Latinos of diverse backgrounds.OBJECTIVE: To examine factors associated with ocular health care utilization among Cuban, Central American, and South American Hispanics/Latinos in a cohort study.DESIGN, SETTING, AND PARTICIPANTS: An ancillary study to the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) evaluating ocular health, knowledge, risk factors, and health care use was conducted with 1235 HCHS/SOL participants (aged ≥40 years) at the Miami, Florida, study site. Data were collected from October 17, 2011, to September 30, 2013, and analyses were conducted from May 28, 2014, to March 18, 2015. Descriptive and multivariable logistic regression analyses were performed for 3 ocular health care outcomes. Regression models were built sequentially with variables conceptually grouped according to Andersen's Behavioral Model of Health Services Use.MAIN OUTCOMES AND MEASURES: Ever having an eye examination, having an eye examination performed within the past 2 years, and difficulty obtaining needed eye care in the past year.RESULTS: Of the 1235 participants, 478 were men and 757 were women, and they had a mean (SD) age of 53.6 (8.1) years. Those who never had insurance were less likely to have had an eye examination (with data reported as odds ratios [95% CIs]) ever, 0.19 (0.07-0.53) and in the past 2 years, 0.22 (0.15-0.33) and were more likely to have had difficulty obtaining needed eye care in the past year (3.72 [1.75-7.93]). Those with less than excellent or good self-rated eyesight were less likely to ever have had an eye examination (0.26 [0.12-0.56]) and more likely to have had difficulty obtaining care (3.00 [1.48-6.11]). Men were less likely to ever have had an eye examination (0.31 [0.18-0.53]). Older (55-64 years) Hispanics/Latinos (3.04 [1.47-6.31]) and those with a high school degree or general educational development certification (2.06 [1.02-4.13]) or higher levels of education (4.20 [2.12-8.30]) were more likely to ever have had an eye examination. Finally, those living in the United States for more than 15 years (0.42 [0.21-0.82]) were less likely to have had difficulty obtaining care.CONCLUSIONS AND RELEVANCE: Our findings suggest that increasing insurance coverage, decreasing the costs of care, and increasing the availability of care for Hispanics/Latinos with poor self-rated eyesight are relevant issues to address to improve ocular health care use among Hispanics/Latinos of diverse backgrounds.

DOI10.1001/jamaophthalmol.2015.5842
Alternate JournalJAMA Ophthalmol
PubMed ID26821791
PubMed Central IDPMC5821234
Grant ListU58 DP002655 / DP / NCCDPHP CDC HHS / United States
5U58DP002653 / DP / NCCDPHP CDC HHS / United States
U58 DP002653 / DP / NCCDPHP CDC HHS / United States
N01HC65236 / HL / NHLBI NIH HHS / United States
N01HC65235 / HL / NHLBI NIH HHS / United States
N01-HC65237 / HC / NHLBI NIH HHS / United States
N01HC65234 / HL / NHLBI NIH HHS / United States
N01HC65233 / HL / NHLBI NIH HHS / United States
N01HC65237 / HL / NHLBI NIH HHS / United States
N01-HC65233 / HC / NHLBI NIH HHS / United States
U58 DP002652 / DP / NCCDPHP CDC HHS / United States
5U58DP002651 / DP / NCCDPHP CDC HHS / United States
N01-HC65234 / HC / NHLBI NIH HHS / United States
N01-HC65236 / HC / NHLBI NIH HHS / United States
1U58DP002655 / DP / NCCDPHP CDC HHS / United States
U58 DP002651 / DP / NCCDPHP CDC HHS / United States
1U58DP002652 / DP / NCCDPHP CDC HHS / United States
N01-HC65235 / HC / NHLBI NIH HHS / United States
MS#: 
0242
Manuscript Lead/Corresponding Author Affiliation: 
Field Center: Miami (University of Miami)
ECI: 
Yes
Manuscript Status: 
Published