Socio-economic differences in accessing NHS spectacles amongst children with differing refractive errors living in Scotland.
Journal
Eye (London, England)
ISSN: 1476-5454
Titre abrégé: Eye (Lond)
Pays: England
ID NLM: 8703986
Informations de publication
Date de publication:
04 2022
04 2022
Historique:
received:
08
07
2020
accepted:
06
04
2021
revised:
02
03
2021
pubmed:
21
4
2021
medline:
15
4
2022
entrez:
20
4
2021
Statut:
ppublish
Résumé
Adults living in more deprived areas are less likely to attend an eye examination, resulting in greater visual impairment from undiagnosed eye disease and a widening of health inequalities. It is unknown if the introduction of free NHS eye examinations and help with spectacle costs has benefited children in Scotland. This study aimed to explore factors associated with accessing NHS spectacles including level of deprivation, refractive error, urbanity and age. NHS-financed General Ophthalmic Services (GOS) 3 supplement the cost of spectacles for children under 16 years. Administrative data on the spectacle refraction dispensed were obtained from Information Services Division (ISD) for mainland Scotland, 2018, and categorised by: Emmetropes/low hyperopes (reference group), myopes and moderate/high hyperopes. Data were linked to the Scottish Index of Multiple Deprivation (SIMD) quintile. Data included 108, 043 GOS 3 claims. Greater deprivation was associated with greater GOS 3 claims p = 0.041. This was most evident in emmetropic/low hyperopic children and in moderate/high hyperopic children. GOS 3 claims in the myopes group increased with age across all SIMD and decreased with age in the moderate/high hyperope group (all p < 0.001). GOS 3 claims were not associated with urbanity for all Health Boards (p = 0.13). Children in areas of greater deprivation and in more rural areas are not disadvantaged in accessing NHS spectacles. This did not vary by refractive error group. This suggests that health policy in Scotland is accessible to those from all deprivation levels and refractive errors.
Sections du résumé
BACKGROUND/OBJECTIVES
Adults living in more deprived areas are less likely to attend an eye examination, resulting in greater visual impairment from undiagnosed eye disease and a widening of health inequalities. It is unknown if the introduction of free NHS eye examinations and help with spectacle costs has benefited children in Scotland. This study aimed to explore factors associated with accessing NHS spectacles including level of deprivation, refractive error, urbanity and age.
SUBJECTS/METHODS
NHS-financed General Ophthalmic Services (GOS) 3 supplement the cost of spectacles for children under 16 years. Administrative data on the spectacle refraction dispensed were obtained from Information Services Division (ISD) for mainland Scotland, 2018, and categorised by: Emmetropes/low hyperopes (reference group), myopes and moderate/high hyperopes. Data were linked to the Scottish Index of Multiple Deprivation (SIMD) quintile.
RESULTS
Data included 108, 043 GOS 3 claims. Greater deprivation was associated with greater GOS 3 claims p = 0.041. This was most evident in emmetropic/low hyperopic children and in moderate/high hyperopic children. GOS 3 claims in the myopes group increased with age across all SIMD and decreased with age in the moderate/high hyperope group (all p < 0.001). GOS 3 claims were not associated with urbanity for all Health Boards (p = 0.13).
CONCLUSIONS
Children in areas of greater deprivation and in more rural areas are not disadvantaged in accessing NHS spectacles. This did not vary by refractive error group. This suggests that health policy in Scotland is accessible to those from all deprivation levels and refractive errors.
Identifiants
pubmed: 33875827
doi: 10.1038/s41433-021-01536-8
pii: 10.1038/s41433-021-01536-8
pmc: PMC8956614
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
773-780Informations de copyright
© 2021. The Author(s).
Références
Dickey H, Ikenwilo D, Norwood P, Watson V, Zangelidis A. Utilisation of eye-care services: the effect of Scotland’s free eye examination policy. Health Policy. 2012;108:286–93.
doi: 10.1016/j.healthpol.2012.09.006
Yip JLY, Khawaja AP, Chan MPY, Broadway DC, Peto T, Luben R, et al. Area deprivation and age related macular degeneration in the EPIC-Norfolk Eye Study. Public Health. 2015;129:103–9.
doi: 10.1016/j.puhe.2014.10.012
McKibbin M, Farragher TM, Shickle D. Monocular and binocular visual impairment in the UK Biobank study: prevalence, associations and diagnoses. BMJ Open. 2018;3:e000076.
doi: 10.1136/bmjophth-2017-000076
Vila-Vidal N, Guisasola L, Rius A, Alonso J, Tresserras R. Children’s visual impairment and visual care related to socioeconomic status in Catalonia (Spain). Child Care Health Dev. 2021;47:94–102.
doi: 10.1111/cch.12826
Rho CR, Kim H, Kim MS, Kim EC. Income and education are independently associated with visual impairment: the Korean National Health and Nutrition Examination Survey 2010-2. Semin Ophthalmol. 2019;34:131–6.
doi: 10.1080/08820538.2019.1597133
Fraser S, Bunce C, Wormald R, Brunner E. Deprivation and late presentation of glaucoma: case-control study. BMJ. 2001;322:639–43.
doi: 10.1136/bmj.322.7287.639
Pradnya M, Hussein A, Smith D, Fraser S, Lotery Andrew J. Socio-economic status and outcomes for patients with age-related macular degeneration. Eye. 2019;33:1224–31.
doi: 10.1038/s41433-019-0393-3
Sharma HE, Mathewson PA, Lane M, Shah P, Glover N, Palmer H, et al. The role of social deprivation in severe neovascular age-related macular degeneration. Br J Ophthalmol. 2014;98:1625–8.
doi: 10.1136/bjophthalmol-2014-304959
Day F, Buchan JC, Cassells-brown A, Fear J, Dixon R, Wood F. A glaucoma equity profile: correlating disease distribution with service provision and uptake in a population in Northern England, UK. Eye. 2010;24:1478–85.
doi: 10.1038/eye.2010.73
Shickle DFT. Geographical inequalities in uptake of NHS-funded eye examinations: small area analysis of Leeds, UK. J Public Health. 2015;37:337–45.
doi: 10.1093/pubmed/fdu039
Solebo AL, Rahi JS. UK National Screening Committee. Childhood vision screening. External review against programme appraisal criteria for the UK National Screening Committee. Version: Final. 2019.
O’Donoghue L, Rudnicka AR, McClelland JF, Logan NS, Saunders KJ. Visual acuity measures do not reliably detect childhood refractive error−an epidemiological study. PLoS ONE. 2012;7:e34441.
doi: 10.1371/journal.pone.0034441
Colburn JD, Morrison DG, Estes RL, Li C, Lu P, Donahue SP. Longitudinal follow-up of hypermetropic children identified during preschool vision screening. J APPOS. 2010;14:211–5.
Williams WR, Latif AHA, Hannington L, Watkins DR. Hyperopia and educational attainment in a primary school cohort. Arch Dis Child. 2005;90:150–3.
doi: 10.1136/adc.2003.046755
Atkinson J, Braddick O, Nardini M, Anker S. Infant hyperopia: detection, distribution, changes and correlates-outcomes from the cambridge infant screening programs. Optom Vis Sci. 2007;84:84–96.
doi: 10.1097/OPX.0b013e318031b69a
O’Donoghue L, McClelland JF, Logan NS, Rudnicka AR, Owen CG, Saunders KJ. Refractive error and visual impairment in school children in Northern Ireland. Br J Ophthalmol. 2010;94:1155–9.
doi: 10.1136/bjo.2009.176040
Williams C, Northstone K, Howard M, Harvey I, Harrad RA, Sparrow JM. Prevalence and risk factors for common vision problems in children: data from the ALSPAC study. Br J Ophthalmol. 2008;92:959–64.
doi: 10.1136/bjo.2007.134700
Lim HT, Yoon JS, Hwang S, Lee SY. Prevalence and associated sociodemographic factors of myopia in Korean children: the 2005 third Korea National Health and Nutrition Examination Survey (KNHANES III). Jpn J Ophthalmol. 2012;56:76–81.
doi: 10.1007/s10384-011-0090-7
Theophanous C, Modjtahedi BS, Batech M, Marlin DS, Luong TQ, Fong DS. Myopia prevalence and risk factors in children. Clin Ophthalmol. 2018;12:1581–7.
doi: 10.2147/OPTH.S164641
Wu LJ, You QS, Duan JL, Luo YX, Liu LJ, Li X, et al. Prevalence and associated factors of myopia in high-school students in Beijing. PLoS ONE. 2015;10:1.
Tang SM, Kam KW, French AN, Yu M, Chen LJ, Young AL, et al. Independent influence of parental myopia on childhood myopia in a dose-related manner in 2,055 trios: the Hong Kong Children Eye Study. Am J Ophthalmol. 2020;218:199–207.
doi: 10.1016/j.ajo.2020.05.026
French AN, Morgan IG, Mitchell P, Rose KA. Risk factors for incident myopia in Australian schoolchildren: the Sydney adolescent vascular and eye study. Ophthalmology. 2013;120:2100–8.
doi: 10.1016/j.ophtha.2013.02.035
O’Donoghue L, Kapetanankis VV, McClelland JF, Logan NS, Owen CG, Saunders KJ, et al. Risk factors for childhood myopia: findings from the NICER study. Investig Ophthalmol Vis Sci. 2015;56:1524–30.
doi: 10.1167/iovs.14-15549
Information Services Division, NHS National Services Scotland. Information Services Division. 2019. https://www.isdscotland.org/ . Accessed 4 Sep 2019.
Scottish Government. Topics: statistics: Scottish Index of Multiple Deprivation: background and methodology. 2016. https://www2.gov.scot/Topics/Statistics/SIMD/BackgroundMethodology . Accessed 4 Sep 2019.
NHS Scotland. Health board areas of NHS Scotland. 2020. https://www.scot.nhs.uk/mapofscotlandshowversion-2/ . Accessed 21 May 2020.
Logan NS, Shah P, Rudnicka AR, Gilmartin B, Owen CG. Childhood ethnic differences in ametropia and ocular biometry: the Aston Eye Study. Ophthalmic Physiol Opt. 2011;31:550–8.
doi: 10.1111/j.1475-1313.2011.00862.x
National Records of Scotland. Mid-2018 population estimates Scotland. 2019. https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/population/population-estimates/mid-year-population-estimates/mid-2018 . Accessed 4 Sep 2019.
National Records of Scotland. Population estimates by urban rural classification (2011 Data Zone based). 2020. https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/population/population-estimates/2011-based-special-area-population-estimates/population-estimates-by-urban-rural-classification . Accessed 15 Dec 2020.
Jonuscheit S, Loffler G, Strang NC. General ophthalmic services in Scotland: value for (public) money? Ophthalmic Physiol Opt. 2019;39:231.
doi: 10.1111/opo.12632
Legge R, Strang NC, Loffler G. Distribution of optometric practices relative to deprivation index in Scotland. J Public Health. 2018;40:389–96.
doi: 10.1093/pubmed/fdx074
McCullough SJ, O’Donoghue L, Saunders KJ. Six year refractive change among White children and young adults: evidence for significant increase in myopia among White UK children. PLoS ONE. 2016;1:1.
Dudovitz RN, Izadpanah N, Chung PJ, Slusser W. Parent, teacher, and student perspectives on how corrective lenses improve child wellbeing and school function. Matern Child Health J. 2016;20:974–83.
doi: 10.1007/s10995-015-1882-z
Hagen LA, Gjelle JVB, Arnegard S, Pedersen HR, Gilson SJ, Baraas RC. Prevalence and possible factors of myopia in Norwegian adolescents. Sci Rep. 2018;8:13479.
doi: 10.1038/s41598-018-31790-y