For low vision specialists and those who consult them
Americans with visual impairment have problems accessing healthcare
October 23, 2009Posted by on
The most recent issue of Ophthalmic Epidemiology has an interesting paper by Spencer and colleagues on access to healthcare by people with visual impairment and blindness in the USA.
It shows quite elegantly that those who are visually impaired have more problems in accessing health care than those with good vision: 8.5% of those with visual impairment reported being unable to access necessary healthcare, compared to 4.6% of those who were legally blind, and 2.6% of those with good vision. Key barriers identified by those with visual impairment were cost, transportation, and insurance issues. Those who were legally blind experienced fewer difficulties than those with visual impairment (perhaps due to the extra benefits which blind certification entitles you to, such as supplementary security income and social security disability income). Legally blind people were, shockingly, more likely to be refused services.
This study was well conducted and corrected for differences in socio-economic status of those who are visually impaired (in this group, the visually impaired were more likely to be older, female, and unmarried than the group with good vision, for example). The study also has impressive statistical power: as a clinical researcher, I am always amazed when I see the number of subjects in most epidemiology papers (over 40,000 in this case).
As the US healthcare debate rumbles on, it is important to address problems with access to health services experienced by those with visual impairment. However, this study also raises wider problems with healthcare access – over 2.5% of people with good vision also report they are unable to get necessary medical care.