To examine whether different government-insured eye care coverage policies affect adolescents' access to eye care providers (ophthalmologists and optometrists) in Canada.
11 015 Canadian adolescents aged 12 to 17 participated in the Canadian Community Health Survey (CCHS) 2007-2008.
Self-reported use of eye care providers, was compared between adolescents with and without government-insured routine eye examinations. The association between the utilization and the government coverage was evaluated by using prevalence ratios (PR) and 95% confidence intervals (CI).
Across Canada, 45.6% of adolescents used eye care providers over a 12-month period. The utilization rate was highest (46.4%) in provinces with insured routine eye examinations, lower (35.9%) in provinces without insured routine eye examinations, and lowest (27.1%) in the 3 territories. Significantly lower utilization rates were also found in males (10% less likely than females); in those without dwelling ownership (19% less likely than those who owned); in those who read fewer than 3 hours weekly (13% less likely than in those who read 3 or more hours per week); and in nondiabetics. After adjusting for the confounding effects of these factors, we found that adolescents living in provinces with uninsured routine eye examinations were 24% less likely to utilize eye care services (PR = 0.76; 95% CI 0.67-0.85); whereas those in the 3 territories were nearly 40% less likely to use eye care providers (PR = 0.63; 95% CI 0.48-0.83) compared to adolescents in provinces with insured routine eye examinations.
Lack of eye care insurance for routine eye examinations has a negative impact on adolescents' access to eye care providers in Canada.