Nichani P, Trope GE, Buys YM, Markowitz SN, Liu SY, Ngo G, Markowitz M, Jin YP
Invest Ophthalmol Vis Sci, 60(9):5451
Publication year: 2019

Presented at the: (1) Association for Research in Vision & Ophthalmology (ARVO) 2019 Annual Meeting in Vancouver, BC, Canada (poster); (2) University of Toronto Department of Ophthalmology & Vision Sciences 2019 Research Day (poster); and (3) 2019 Annual Meeting and Exhibition of the Canadian Ophthalmological Society (COS) in Québec City, QC, Canada (paper).

Purpose : This analysis aims to: 1) determine the frequency and source of eyeglass insurance coverage in Ontario and changes from 2003 to 2013/14; 2) examine socio-demographic factors associated with eyeglass insurance; and 3) investigate if having eyeglass insurance is associated with increased use of eye care providers in a publicly-funded healthcare system.

Methods : Cross-sectional data from Ontario respondents aged 12+ to the Canadian Community Health Survey in 2003 (n=42,777), 2005 (n=41,766) and 2013/14 (n=42,553) was analyzed.

Results : Insurance covered all or part of the cost of prescription eyewear for 62.3% of Ontarians in 2003, 62.1% in 2005, and 62.0% in 2013/14. In 2005, 86% of those covered had employer-sponsored insurance, 9% had government-sponsorship, and 6% had a private plan. Corresponding numbers were 84%, 10% and 7% in 2013/14. From 2005 to 2013/14, government coverage increased from 29% to 42% (p<0.0001) for those without a secondary school diploma and from 30% to 38% (p<0.0001) for those with household income under middle-level. Employer-sponsored coverage remained unchanged (92%) for individuals with household income above middle-level but decreased from 67% to 55% (p<0.0001) for Ontarians without a secondary school diploma and from 64% to 53% (p<0.0001) for those with under middle-level income. An estimated 4.2 million Ontarians did not have any source of insurance in 2013/14.

In all survey years, factors associated with having insurance were age <65, post-secondary education, household income above middle-level, aboriginal status, and those in married/common-law relationships.

In age groups with routine eye exams covered by government, having eyeglass insurance versus none was associated with increased use of eye care providers with a difference of 6% for the 12-19 group and 7% for the 65+ group. Among those without government-funded routine eye exams, the difference in use of eye care providers between those with and without eyeglass insurance was 15% for the 20-39 group and 11% for the 40-64 group.

Conclusions : Eyeglass insurance coverage was 62% in Ontario and varied little from 2003 to 2013/14. The largest source of insurance was employer-sponsored, primarily covering high income earners; government insurance significantly increased in lower income and education groups in recent years. Having eyeglass insurance was associated with significantly increased use of eye care providers.

Acknowledgements: This research was supported by funds to the Canadian Research Data Centre Network (CRDCN) from the Social Science and Humanities Research Council (SSHRC), the Canadian Institute for Health Research (CIHR), the Canadian Foundation for Innovation (CFI) and Statistics Canada. Although the research and analysis are based on data from Statistics Canada, the opinions expressed do not represent the views of Statistics Canada or the Canadian Research Data Centre Network (CRDCN).