Factors Associated with Annual Vision Screening in Diabetic Adults: Analysis of the 2019 National Health Interview Survey

Abstract

Purpose

To determine the association(s) between receiving an annual eye exam and various economic, social, and geographic factors assessed in the 2019 National Health Interview Survey (NHIS) among adults with diabetes.

Patients and Methods

Data from adults 18 years of age and older relevant to self-reported non-gestational diabetes diagnosis and eye exam within the last 12 months were extracted from the 2019 NHIS dataset. A multivariate logistic regression model was used to determine associations between receiving an eye exam in the preceding 12 months and various economic, insurance-related, geographic, and social factors. Outcomes were reported as odds ratios (OR) with 95% confidence intervals (CI).

Results

Among diabetic adults in the US, receiving an eye exam within the last 12 months was significantly associated with female sex (OR 1.29; 95% CI 1.05–1.58), residence in the Midwestern United States (OR 1.39; 95% CI 1.01–1.92), use of Veteran’s Health Administration healthcare (OR 2.15; 95% CI 1.34–3.44), having a usual place to go for healthcare (OR 3.89; 95% CI 2.16–7.01), and the use of Private, Medicare Advantage, or other insurance (OR 3.66; 95% CI 2.42–5.53), use of Medicare only excluding Medicare Advantage (OR 3.18; 95% CI 1.95–5.30), dual eligibility for Medicare and Medicaid (OR 3.88; 95% CI 2.21–6.79), and use of Medicaid and other public health insurance (OR 3.04; 95% CI 1.89–4.88) compared to those without insurance. An educational attainment of less than high school (OR 0.66; 95% CI 0.48–0.92), and an educational attainment of high school or GED without any college (OR 0.62; 95% CI 0.47–0.81) reduced the odds of having an annual eye exam.

Conclusion

Economic, social, and geographic factors are associated with diabetic adults receiving an annual eye exam.

Keywords:

• diabetic retinopathy
• insurance
• high deductible health plan
• veteran
• social determinants of health
• preventative health

Acknowledgments

We thank Joanne Li (Northwestern University) for assistance with manuscript proofreading. The study resulting in this publication was assisted by funding through the Summer Research Scholars Program administered by The Feinberg School of Medicine. The conclusions, opinions, and other statements in this publication are the authors’ and not necessarily those of the sponsoring institution.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This research was supported by an unrestricted grant from Research to Prevent Blindness (RPB) NY, NY. Alec. N.A. Jotte was supported by the Northwestern University Feinberg School of Medicine’s Summer Research Scholars Program (SRSP).