Older adults with chronic vision impairment and access to health care in the u.s

Gaps exist in understanding access to general medical and eye care factors for patients with chronic vision impairment (VI) in the U.S., in how eye care access is measured, and available methodologies that quantify access factors and relationships. This research identifies patient and provider characteristics associated with potential and realized health care access, utilizing a novel state-level measure of access to vision rehabilitation (VR) care, and investigates the relationship between potential access to eye care and VR access for adults with VI. Population characteristics were identified from the Behavioral Risk Factor Surveillance System survey from 2005-2010. Age, education, income, gender and race were associated with reported potential and realized access variables. Potential access to VR care varied across states and under varying assumptions of clinician/population estimates. A lack of association was found between potential access to VR care and access to eye care. This is the first to provide a national estimate of geographic VR care accessibility - a key factor in further investigating underuse and continuity of eye care and primary/specialty clinician relationships – and explore a framework of eye care access as related to overall health care whose findings support identified theoretical access factors. New evidence provides support for policies that mitigate factors limiting potential access and use of novel clinical care and care access models. Identified disparities in reported potential access related to income and health insurance status support the need for investigation into third party coverage aimed at appropriate ye care for adults with chronic conditions.