The association between physical disability and eye care utilization among elderly population in Taiwan: A nationwide cohort study

Medical utilization by elderly population is influenced by a number of factors, and physical disabilities may play an important role. Despite the fact that extensive studies have been carried evaluating medical utilization by older individuals, little is known regarding the impact of physical disabilities on eye care utilization. Using datasets from the Taiwan National Health Interview Survey and National Health Insurance (NHI) system, a sample of 1726 elderly people was obtained for analysis. Older persons with worse Activity of Daily Living (ADL) disabilities were less likely to have eye care (odds ratio (OR): 0.39, 95% confidence interval (CI): 0.25-0.62), but elderly who had Instrumental Activity of Daily Living (IADL) disabilities alone were not associated with lower odds (OR = 0.86, 95% CI = 0.61-1.20). In addition to the above, female individuals (OR = 1.91, 95% CI = 1.44-2.53), those with poorer vision (OR = 1.89, 95% CI = 1.36-2.62), those having eye discomfort (OR = 1.66, 95% CI = 1.26-2.18 and OR = 2.14, 95% CI = 1. 32-3.46 respectively for mild and more than moderate eye discomfort), and those with severe eye disease (OR = 1.96, 95% CI = 1.23-3.10) were more likely to undergo eye care. In conclusion, physical disability is a strong risk factor for lack of eye care utilization among older Taiwanese. The barriers associated with low eye care utilization among individuals with ADL disabilities should be explored in order to facilitate effective policy implementation among those elderly with disabilities so that they are able to receive appropriate eye care.