Ophthalmic health care needs of children with disabilities

Backgrounds: Although vision care is crucial for pediatric eye health, research on vision care utilization by children with disabilities remains limited. Furthermore, no study has investigated the variations among various disability types and the interaction between disability status and age. Methods: All children with disabilities listed in the Taiwan National Disability Registry during the study period (2015–2019) were matched by age and sex at a 1:4 ratio with children without disabilities. Vision care needs were measured on the basis of (1) the number of outpatient ophthalmology visits, (2) total medical costs associated with outpatient ophthalmology visits, and (3) whether ophthalmic care was provided. Generalized estimating equation models were estimated to determine the relationships between utilization, disability status, and age. Results: Significant differences in needs between various disability types were identified. Other than children with visual disability, children with facial disability and balance abnormalities also had considerable needs. Children with intellectual disabilities, which constituted the most common disability type (29.4% in 2019), had fewer visits (mean = 1.38, SD = 2.12) and lower medical costs, compared with the averages for all children with disabilities. Care utilization shared an inverted U-shaped relationship with age. Conclusions: Children with disabilities have higher vision care needs, which vary by disability type and age. Such needs are greater at younger ages and decreases after the ages of 9–10 years. Policies should be specific to disability type and age to ensure vision care needs are met.