Are there disparities for eye care utilization under a universal national health insurance program for children with eye diseases?

Objectives: To investigate the factors associated with eye care utilization under a universal national health insurance program for children with eye diseases. Methods: Cross sectional, population based study. 2469 children among 3-12 year old in 2005 National Health Interview Survey (NHIS) were included. Subjects were grouped by eye disease status as reported by caregivers, and linked to their actual eye care utilization obtained from National Health Insurance claim data in 2006. Eye care utilization for specific diseases was defined by ICD_9 CM codes. Multivariate logistic regression was used. Principle findings: 710 children (28.8%) had caregiver reported eye diseases, 56.3 % of them did not visit ophthalmologist for their eye diseases during the subsequent year. Children with reported eye diseases were more likely to have eye care utilization (OR=2.46 95% CI 1.95~3.11). For children with eye disease, income was not associated with eye care utilization, but higher mother's educational level was associated with more eye care utilization (OR=2.01 95% CI 1.17~3.47). Youngest (3-4 year old) children with eye diseases were less likely to have eye care compared with other age groups. Conclusions and policy implications: Although regular eye care by eye professional is important for children with eye diseases, more than half of them did not receive eye cares. Children's age, residential area and mother's education level were significantly associated with eye care utilization, but family income, children's gender, and urbanization levels were not. Socioeconomic and demographic factors should be taken into consideration when designing eye care enhancing programs for children.