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- Access to Care (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 7 of 7 Research Studies DisplayedOke I, Slopen N, Hunter DG
Vision testing for adolescents in the US.
The purpose of this cross-sectional study was to characterize patterns in vision testing as a function of age among United States adolescents and identify sociodemographic factors related with vision testing. The researchers utilized data from 24,752 adolescent children (aged 12 to <18 years) from the 2018-2019 National Survey of Children's Health, a nationally representative survey of the noninstitutionalized United States pediatric population. The primary outcome of the study was the caregiver report of vision testing within the last 12 months. Vision testing in any setting within the previous year was reported by caregivers of 18,621 adolescents. Vision testing was reported to have occurred at an eye clinic in 13,323 participants, at a primary care clinic in 5,230 participants, at a school in 2,594 participants, and at a health center in 635 participants. The rate of adolescents reported to have vision tested decreased with age due to a decrease in testing in primary care and school settings. After adjusting for age and sex, there were lower odds of vision testing reported for adolescents who were uninsured vs insured, had caregivers with less than vs greater than high school education, and were from a family born outside vs inside the United States.
AHRQ-funded; HS000063.
Citation: Oke I, Slopen N, Hunter DG .
Vision testing for adolescents in the US.
JAMA Ophthalmol 2023 Nov; 141(11):1068-72. doi: 10.1001/jamaophthalmol.2023.4475..
Keywords: Children/Adolescents, Eye Disease and Health, Screening
Oke I, Lutz SM, Hunter DG
Use and costs of instrument-based vision screening for US children aged 12 to 36 months.
This research letter describes a cohort study that examined patterns and out-of-pocket costs of instrument-based vision screening among US children 12 to 36 months. The authors used 2018 MarketScan Commerical Claims and Encounters data as of January 1, 2018 and excluded those with fewer than 12 months of continuous insurance coverage, enrollment in capitated insurance plans, no preventive care encounters, or missing data on residents. The study included 246,077 children. Instrument-based vision screening was received by 19.5% (n = 48,101) of children during 2018. Median (IQR) practitioner payment for instrument-based vision screening claims was $13. Screening incurred out-of-pocket expenses for 7% of children; 30% of these children had expenses related to co-payment, 20.2% to coinsurance, and 50.7% to deductibles. Median (IQR) out-of-pocket expense was $11. Increased odds of vision screening were associated with older age, high-deductible plan enrollment, having more than 1 preventative visit, and receiving care within an area in the highest quartile of practitioner payment. This study was limited by use of commercial claims data, which excluded 45% of children with public or no coverage. Nationwide prevalence of vision screening therefore may differ for the general population.
AHRQ-funded; HS000063.
Citation: Oke I, Lutz SM, Hunter DG .
Use and costs of instrument-based vision screening for US children aged 12 to 36 months.
JAMA Pediatr 2023 Jul; 177(7):728-30. doi: 10.1001/jamapediatrics.2023.0808..
Keywords: Newborns/Infants, Eye Disease and Health, Screening, Prevention, Healthcare Costs
Lock LJ, Channa R, Brennan MB
Effect of health system on the association of rurality and level of disadvantage with receipt of diabetic eye screening.
The goal of this retrospective cohort study was to determine the role of level of disadvantage in diabetic eye screening to explain the effect of health systems on rural and urban disparities. Researchers used an all-payer, statewide claims database to include adult Wisconsin residents with diabetes who had claims billed throughout the baseline and measurement years. Results indicated that patients from urban underserved clinics were more likely to receive screening than those from rural underserved clinics; similar findings emerged for both Medicare and non-Medicare subgroups. The researchers concluded that health systems, especially those that serve urban underserved populations, have an opportunity to increase screening rates by leveraging health system-level interventions and supporting patients in overcoming barriers.
AHRQ-funded; HS026279.
Citation: Lock LJ, Channa R, Brennan MB .
Effect of health system on the association of rurality and level of disadvantage with receipt of diabetic eye screening.
BMJ Open Diabetes Res Care 2022 Dec;10(6):e003174. doi: 10.1136/bmjdrc-2022-003174..
Keywords: Rural Health, Access to Care, Screening, Diabetes, Eye Disease and Health, Disparities, Chronic Conditions, Health Systems
Chou R, Selph S, Blazina I
Screening for glaucoma in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
This evidence report and systematic review updated the 2013 USPSTF final recommendation to assess benefits and harms of screening for primary open-angle glaucoma (OAG) in adults. After an extensive literature review, 83 studies were included (30 trials and 53 diagnostic accuracy studies). One randomized clinical trial (RCT) found screening of frail elderly persons associated with no difference in vision outcomes vs no screening but with significantly greater falls risk. There was limited direct evidence on glaucoma screening, with no association of benefits.
AHRQ-funded; 290201500011I.
Citation: Chou R, Selph S, Blazina I .
Screening for glaucoma in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 May 24;327(20):1998-2012. doi: 10.1001/jama.2022.6290..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Eye Disease and Health, Prevention, Guidelines, Evidence-Based Practice
Jonas DE, Amick HR, Wallace IF
Vision screening in children aged 6 months to 5 years: Evidence report and systematic review for the US Preventive Services Task Force.
The researchers reviewed the evidence on screening for and treatment of amblyopia, its risk factors, and refractive error in children aged 6 months to 5 years to inform the US Preventive Services Task Force. They concluded that studies directly evaluating the effectiveness of screening were limited and do not establish whether vision screening in preschool children is better than no screening.
AHRQ-funded; 290201200015I.
Citation: Jonas DE, Amick HR, Wallace IF .
Vision screening in children aged 6 months to 5 years: Evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2017 Sep 5;318(9):845-58. doi: 10.1001/jama.2017.9900.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Eye Disease and Health, Children/Adolescents, Screening, Newborns/Infants
Chou R, Dana T, Bougatsos C
Screening for impaired visual acuity in older adults: updated evidence report and systematic review for the US Preventive Services Task Force.
This update of a 2009 systematic review on screening for impaired visual acuity among older adults found that new evidence on the diagnostic accuracy of visual acuity screening tests was limited and consistent with previous findings that screening questions or a visual acuity test was associated with suboptimal accuracy. Direct evidence found no significant difference between vision screening in older adults in primary care settings vs no screening for improving visual acuity or other clinical outcomes.
AHRQ-funded.
Citation: Chou R, Dana T, Bougatsos C .
Screening for impaired visual acuity in older adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2016 Mar 1;315(9):915-33. doi: 10.1001/jama.2016.0783.
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Keywords: Diagnostic Safety and Quality, Evidence-Based Practice, Eye Disease and Health, Primary Care, Screening, U.S. Preventive Services Task Force (USPSTF)
Press VG, Matthiesen MI, Ranadive A
Insights into inpatients with poor vision: a high value proposition.
The researchers studied the initial feasibility and efficacy of screening and correcting inpatients’ vision. Over 800 hospitalized patients’ vision was screened. Those participants who failed a vision screen (Snellen chart) test performed by research assistants were given non-prescription readers that corrected most participants’ vision.
AHRQ-funded; HS016967.
Citation: Press VG, Matthiesen MI, Ranadive A .
Insights into inpatients with poor vision: a high value proposition.
J Hosp Med 2015 May;10(5):311-3. doi: 10.1002/jhm.2342..
Keywords: Eye Disease and Health, Screening, Inpatient Care, Hospitalization