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Résumé (français)

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Résumé (anglais)

Purpose : This analysis aims to: 1) determine the frequency and source of eyeglass insurance coverage in Ontario and changes from 2003 to 2013/14; 2) examine socio-demographic factors associated with eyeglass insurance; and 3) investigate if having eyeglass insurance is associated with increased use of eye care providers in a publicly-funded healthcare system. Methods : Cross-sectional data from Ontario respondents aged 12+ to the Canadian Community Health Survey in 2003 (n=42,777), 2005 (n=41,766) and 2013/14 (n=42,553) was analyzed. Results : Insurance covered all or part of the cost of prescription eyewear for 62.3% of Ontarians in 2003, 62.1% in 2005, and 62.0% in 2013/14. In 2005, 86% of those covered had employer-sponsored insurance, 9% had government-sponsorship, and 6% had a private plan. Corresponding numbers were 84%, 10% and 7% in 2013/14. From 2005 to 2013/14, government coverage increased from 29% to 42% (p<0.0001) for those without a secondary school diploma and from 30% to 38% (p<0.0001) for those with household income under middle-level. Employer-sponsored coverage remained unchanged (92%) for individuals with household income above middle-level but decreased from 67% to 55% (p<0.0001) for Ontarians without a secondary school diploma and from 64% to 53% (p<0.0001) for those with under middle-level income. An estimated 4.2 million Ontarians did not have any source of insurance in 2013/14. In all survey years, factors associated with having insurance were age <65, post-secondary education, household income above middle-level, aboriginal status, and those in married/common-law relationships. In age groups with routine eye exams covered by government, having eyeglass insurance versus none was associated with increased use of eye care providers with a difference of 6% for the 12-19 group and 7% for the 65+ group. Among those without government-funded routine eye exams, the difference in use of eye care providers between those with and without eyeglass insurance was 15% for the 20-39 group and 11% for the 40-64 group. Conclusions : Eyeglass insurance coverage was 62% in Ontario and varied little from 2003 to 2013/14. The largest source of insurance was employer-sponsored, primarily covering high income earners; government insurance significantly increased in lower income and education groups in recent years. Having eyeglass insurance was associated with significantly increased use of eye care providers.