Blindness, Visual Impairment and Access to Health Care Services

OBJECTIVES: This study uses a nationally representative dataset to describe the association between visual impairment and blindness and access to medical services.

METHODS: Data from the Medical Expenditure Panel Survey from 2002 to 2004 were pooled to assess the effect of visual impairment and blindness on access to medical care for individuals aged 40 years and older. We examined the relationship between vision measures and delay and inability to obtain necessary medical care, prescription medications, and dental care. We also determined whether vision status was related to whether a person had a usual source of care.

FINDINGS: Compared with non-visually impaired person (N=36,666), individuals with blindness (N=227) and visual impairment (N=3,750) were less likely to be married, have self-reported “excellent/very good” health status, or to be highly educated; they also had lower mean income and were more likely to have public health insurance. In comparison to the non-visually impaired, visual impairment had a stronger relationship with access to care variables than did blindness. Although visual impairment was not significantly related to having a usual source of care, individuals with visual impairment were more likely than non-impaired persons to delay obtaining necessary medical care (O.R.= 2.31), prescription medications(O.R.=2.21), and dental treatment(O.R.= 2.29), or be unable to obtain necessary medical care(O.R.= 2.218), prescription medications (O.R.= 2.10), and dental treatment (O.R.= 2.32).

CONCLUSION: Visual impairment is associated with lower access to basic medical services. Individuals with blindness may access services and benefits that are not necessarily available to individuals with visual impairment.