Barriers to Eye Care Among People Aged 40 Years and Older With Diagnosed Diabetes, 2006-2010

OBJECTIVEWe examine barriers to receiving recommended eye care among people aged 40 years with diagnosed diabetes.RESEARCH DESIGN AND METHODSWe analyzed 2006-2010 Behavioral Risk Factor Surveillance System data from 22 states (n = 27,699). Respondents who had not sought eye care in the preceding 12 months were asked the main reason why. We categorized the reasons as cost/lack of insurance, no need, no eye doctor/travel/appointment, and other (meaning everything else). We used multinomial logistic regression to control for race/ethnicity, education, income, and other selected covariates.RESULTSAmong adults with diagnosed diabetes, nonadherence to the recommended annual eye examinations was 23.5%. The most commonly reported reasons for not receiving eye care in the preceding 12 months were no need and cost or lack of insurance (39.7 and 32.3%, respectively). Other reasons were no eye doctor, no transportation or could not get appointment (6.4%), and other (21.5%). After controlling for covariates, adults aged 40-64 years were more likely than those aged 65 years (relative risk ratio [RRR] = 2.79; 95% CI 2.01-3.89) and women were more likely than men (RRR = 2.33; 95% CI 1.75-3.14) to report cost or lack of insurance as their main reason. However, people aged 40-64 years were less likely than those aged 65 years to report no need (RRR = 0.51; 95% CI 0.39-0.67) as their main reason.CONCLUSIONSAddressing concerns about cost or lack of insurance for adults under 65 years and no perceived need among those 65 years and older could help improve eye care service utilization among people with diabetes.