Study finds ophthalmic care disparities between North American Native, white individuals
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North American Native individuals had a higher rate of ophthalmic conditions but no coinciding increase in ophthalmic care compared with non-Hispanic white individuals, according to a study published in JAMA Ophthalmology.
“This study brings awareness that the disparity exists at a national level even among persons who have insurance across North American Native groups,” study author Maria A. Woodward, MD, MSc, told Healio/OSN.
![“Even with parity insurance coverage, [North American Native individuals] have negatively discrepant eye care in most all categories,” Kathleen Hughes, MBA](/~/media/slack-news/ophthalmology/misc/infographics/12_december/02_february/osn0122hughes_itj_graphic_01_web.jpg?w=800)
Woodward and colleagues conducted a cross-sectional study using Medicare fee-for-service data from the Vision and Eye Health Surveillance System to investigate ophthalmic conditions and service data among North American Native individuals and non-Hispanic white individuals in the U.S. North American Native individuals included people who identified as American Indian, Native Alaskan, Native Hawaiian and Pacific Islander.
The study identified claims for 177,100 North American Native individuals and 24,438,000 non-Hispanic white individuals. North American Native individuals had a higher condition claim rate and lower service claim rate than non-Hispanic white individuals for refractive errors (17.2 vs. 11.1 and 48.3 vs. 49.6, respectively; P < .001), injuries, burns and surgical complications (1.8 vs. 1.7 and 19.2 vs. 20.1, respectively; P < .001), blindness and low vision (1.48 vs. 0.75 and 19.2 vs. 20.1, respectively; P<.001) and orbital and external disease (15.7 vs. 13.3 and 48.3 vs. 49.6, respectively; P<.001).
In cases of diabetic eye diseases, North American Native individuals had a higher claim rate (5.22 vs. 2.20; P < .001), but there was no statistically significant difference in service claim rate (14.4 vs. 14.8).
“Even with parity insurance coverage, [North American Native individuals] have negatively discrepant eye care in most all categories,” study author Kathleen Hughes, MBA, told Healio/OSN. “We need to advocate for and pass legislation for corrective lenses for myopia, presbyopia, astigmatism and like conditions occurring outside the context of surgery to be added as a Medicare covered benefit, as they fit the definition of ‘medically necessary.’”
Hughes also called for expanded access to eye care services and ensuring there are adequate referral services for secondary and tertiary care.
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Woodward MA, et al. JAMA Ophthalmol. 2021;doi:10.1001/jamaophthalmol.2021.5507.
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