Health Insurance Coverage and Use of Eye Care Services

Objective  To compare realized access or use of eye care services in adults with self-reported vision problems in Canada and the United States.

Methods  Using the Joint Canada/United States Survey of Health, we examined the differences in use of eye care services in 2018 Canadian respondents and 2930 American respondents with self-reported vision problems. We performed multivariate logistic regression analyses to estimate the probability that individuals with vision problems and various insurance categories would visit an eye care professional.

Results  Approximately 8.2% of Americans with self-reported vision problems did not have health insurance. Americans without health insurance had the lowest age-adjusted rate of use of eye care services (42%) compared with Americans with private health insurance (67%) or public health insurance (55%) and Canadians (56%). The difference in use of eye care services between Americans without health insurance and Canadians narrowed when adjusted for income level and was almost eliminated when adjusted for having optional vision insurance. Individuals with optional vision insurance and those with higher income levels were more likely to use eye care services.

Conclusions  Americans with vision problems who had health insurance accessed eye care services at a rate higher than or equal to that of their Canadian counterparts. The gap in access between Canadians and Americans without health insurance narrowed after adjustments for income level and optional vision insurance.

Publication date

March 19, 2015


Paul Lee, Theodore Thompson, Sanjay Sharma, Lawrence Barker, Linda Geiss, Giuseppina Imperatore, Edward Gregg, Xuanping Zhang & Jinan Saaddine

Sponsor Institution

JAMA Ophthalmology


Xinzhi Zhang
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