Objective: To explore the prevalence and demographics of financial insecurity in individuals with eye disease in the United States.
Methods: This retrospective cross-sectional study analysed questions from the nationally representative 2016-2017 National Health Interview Survey (NHIS) with the eye conditions macular degeneration, diabetic retinopathy, glaucoma, and cataract. Data was analysed as a whole and then further analysed by condition. Evaluated topics indicated financial insecurity such as individuals reporting difficulty paying bills among eye conditions studied and by demographics.
Results: Survey responses estimated that the overall prevalence of reporting problems paying or unable to pay bills were 12.49% (95% C.I. 11.62-13.36%) among patients with eye conditions. The overall prevalence of patients delaying care was 6.77% (95% C.I. 6.17-7.36%) and 17.06% (95% C.I. 15.99-18.14%) of individuals with eye conditions reported worrying about housing payments. Multivariable logistic regression revealed that demographics who more frequently had difficulty paying medical bills include individuals age 45-64 (3.33 aOR, C.I. 2.79-3.98, p < 0.001), blacks (1.90 aOR, C.I., 1.48-2.45, p < 0.001), Hispanics (1.51 aOR, C.I. 1.07-2.12, p = 0.020), and those 100-200% of the federal poverty line (2.16 aOR, C.I. 1.76-2.66, p < 0.001) or below the poverty line (1.93 aOR, C.I. 1.48-2.53, p < 0.001).
Conclusion: There are several demographics with eye disease that self-report financial insecurity. There should be greater concern for financial insecurity among diabetic retinopathy and glaucoma patients. Ophthalmologists should consider engaging in proactive discussions with at-risk patients to reduce potential non-adherence secondary to financial insecurity.
© 2021. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.