Association between community outpatient clinic care accessibility and the uptake of diabetic retinopathy screening: A multi-level analysis. Issue 6 (December 2020)

• Record Type: Journal Article
• Authors: Youn, Hin Moi; Lee, Doo Woong; Park, Eun-Cheol
• Is Part Of: Primary care diabetes. Volume 14:Issue 6(2020)
• Page Start: 616
• Page End: 621
• Publication Date: 2020-12
• Subjects: DR Diabetic retinopathy -- CHS Community health survey -- CI Confidence interval -- HIRA Health insurance review & assessment service -- OR Odds ratio -- ICC Intraclass correlation coefficient; Diabetic retinopathy -- Fundus examination -- Healthcare resources -- Diabetes -- Visual impairment -- Blindness -- Prevention -- Outpatient clinic -- Accessibility; Diabetes -- Periodicals; 616.462
• DOI: 10.1016/j.pcd.2020.02.010
• Languages: English
• ISSNs: 1751-9918

Abstract

Highlights: Diabetic retinopathy (DR) is a leading cause of vision impairment and blindness. Early detection can prevent up to 98% of visual impairment due to DR. This study found that the fundus examination uptake rate in Korea was 34.4%. Screening for diabetes-related eye complications is underutilized in Korea. Community-level accessibility may aid in the promotion of regular eye screening. Abstract: Aims: To investigate the uptake rate variance of fundus examination for diabetes-related complications among demographically and geographically diverse communities and examine determinants that influence this rate focusing on outpatient eye care clinic accessibility at community level. Methods: Data of 20, 904 participants with diabetes from 228 communities in 2015 were collected from the nationwide Community Health Survey and Statistics Korea. Outpatient eye care clinic accessibility was measured by the number of eye clinics per 1000 population. Multilevel analysis was conducted to assess the fundus examination uptake rate across communities and examine the association of individual- and community-level determinants with this rate. Results: The uptake rate among patients with diabetes was 34.8% and varied across communities. At the individual level, determinants related to knowledge and awareness were significantly positively associated with fundus examination uptake. At the community level, increases in the number of eye clinics were associated with significant increases in fundus examination uptake (OR 1.21; 95% CI 1.03–1.43). Conclusions: Based on the result that outpatient eye care clinic accessibility was significantly associated with the uptake rate across communities, improving accessibility may be an important factor and should be considered when developing interventions for promoting regular diabetic retinopathy screening. This will lead to earlier detection of complications and minimize diabetes-related visual impairment.