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Impact of geographic density of eye care professionals on eye care among adults with diabetes.

Publication ,  Journal Article
Chou, C-F; Zhang, X; Crews, JE; Barker, LE; Lee, PP; Saaddine, JB
Published in: Ophthalmic Epidemiol
December 2012

OBJECTIVE: To examine the impact of the geographic density of eye care professionals (ECPs) on the receipt of annual dilated eye examinations among adults in the United States with diabetes. METHOD: Data from the 2006 Behavioral Risk Factor Surveillance System were linked to the 2007 Area Resource File to examine the association between the density of ECPs (ophthalmologists and optometrists) per 100,000 people and self-reports of having had a dilated eye examination in the last year. The sample included adults aged 18+ years with diabetes (N = 29,495). Multivariate logistic regression was conducted to estimate adjusted odds ratios of annual dilated eye examinations, while controlling for age, sex, marital status and education, and stratifying by health insurance. RESULTS: Approximately 10% of respondents with diabetes lived in counties with no ECPs. Prevalence of being uninsured was 7.4% and 15.5% in those with and without dilated eye exams, respectively. After controlling for covariates and stratifying by health insurance, diabetic adults with health insurance cover residing in areas with no ECPs were less likely to report having had a dilated eye examination in the past year than those with 20 or more ECPs/100,000 people (odds ratio 0.72, 95% confidence interval 0.58-0.91). CONCLUSION: Residence in a county with a low density of ECPs reduced the likelihood of receiving annual dilated eye examinations among insured adults with diabetes. Enhancing the ability of ECPs to reach and care for those in need might better protect vision in people with diabetes. More research is needed to determine the mix of services that produces the best patient outcome.

Duke Scholars

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Published In

Ophthalmic Epidemiol

DOI

EISSN

1744-5086

Publication Date

December 2012

Volume

19

Issue

6

Start / End Page

340 / 349

Location

England

Related Subject Headings

  • Young Adult
  • Workforce
  • Primary Health Care
  • Population Surveillance
  • Physical Examination
  • Ophthalmology
  • Middle Aged
  • Male
  • Humans
  • Health Services Accessibility
 

Citation

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Chou, C.-F., Zhang, X., Crews, J. E., Barker, L. E., Lee, P. P., & Saaddine, J. B. (2012). Impact of geographic density of eye care professionals on eye care among adults with diabetes. Ophthalmic Epidemiol, 19(6), 340–349. https://doi.org/10.3109/09286586.2012.722244
Chou, Chiu-Fang, Xinzhi Zhang, John E. Crews, Lawrence E. Barker, Paul P. Lee, and Jinan B. Saaddine. “Impact of geographic density of eye care professionals on eye care among adults with diabetes.Ophthalmic Epidemiol 19, no. 6 (December 2012): 340–49. https://doi.org/10.3109/09286586.2012.722244.
Chou C-F, Zhang X, Crews JE, Barker LE, Lee PP, Saaddine JB. Impact of geographic density of eye care professionals on eye care among adults with diabetes. Ophthalmic Epidemiol. 2012 Dec;19(6):340–9.
Chou, Chiu-Fang, et al. “Impact of geographic density of eye care professionals on eye care among adults with diabetes.Ophthalmic Epidemiol, vol. 19, no. 6, Dec. 2012, pp. 340–49. Pubmed, doi:10.3109/09286586.2012.722244.
Chou C-F, Zhang X, Crews JE, Barker LE, Lee PP, Saaddine JB. Impact of geographic density of eye care professionals on eye care among adults with diabetes. Ophthalmic Epidemiol. 2012 Dec;19(6):340–349.

Published In

Ophthalmic Epidemiol

DOI

EISSN

1744-5086

Publication Date

December 2012

Volume

19

Issue

6

Start / End Page

340 / 349

Location

England

Related Subject Headings

  • Young Adult
  • Workforce
  • Primary Health Care
  • Population Surveillance
  • Physical Examination
  • Ophthalmology
  • Middle Aged
  • Male
  • Humans
  • Health Services Accessibility