犹他州在哪些方面取得了成功, and where is it falling short in providing eye care to the state’s most underserved groups?
A recent survey of eye care providers and stakeholders identified screening and care for diabetes-related 愿景 loss as the most urgent need for residents on the Navajo Nation, people experiencing homelessness, 前难民, and underinsured or uninsured Utahns. Vision screenings for children and access to eyeglasses came in a close second.
The insights are part of the ongoing Utah Assessment and Review of Community Health Eye Care Study (ARCHES), launched in 2020 by a team of 约翰一. 莫兰眼科中心 and University of Utah healthcare professionals.
而莫兰 全球外联部 provides donor-funded charitable care to thousands of Utahns each year at clinics around the state and on the Navajo Nation, the need for care outpaces capacity. Spearheaded by Outreach Di愿景 Medical Director 克雷格·J. 马里兰州兴高采烈, University of Utah Di愿景 of Public Health Associate Professor 莎伦·托尔博伊斯博士和莫兰居民 肖恩·科隆，医学博士, ARCHES addresses the challenge by bringing more voices and providers to the table.
Preserving 愿景 is an investment in our communities that allows our neighbors to fully participate in society, 找工作或保住工作, 关心他们所爱的人, 参加学校活动,查亚说。. “ARCHES is providing a roadmap for a coordinated, statewide response to providing eye care where it’s needed most.”
Top Priorities and Barriers to Eye Care
With 61 responses from ophthalmologists, 验光师, and 愿景 heath stakeholders, the survey responses mirrored the state’s geographic population distribution. Respondents named screening and care for 糖尿病性视网膜病变 as their top priority for underserved residents.
Diabetic retinopathy causes irreversible 愿景 loss as it changes the blood vessels in the retina in the back of the eye. It is the most common diabetic eye disease and a leading cause of blindness in American adults, but many patients skip screenings and timely treatment due to the cost of care. Only one survey respondent reported more than 50% of their underserved diabetic patients were up to date on their annual eye screening—a necessary sight-saving precaution.
In 2021, Moran’s 全球外联部 launched a monthly Hope in Sight Retina Clinic to address this dire need with ongoing monitoring and care, including laser treatments and injections. But it is only the first step, initially serving a small number of patients.
Vision screening for children and access to eyeglasses tied as the second most urgent eye care need, 根据调查.
The greatest perceived barrier to care among patients involved the cost of care or lack of insurance, according to the respondents. The cost of missing work and lack of transportation were the second most significant barriers, closely followed by a lack of awareness about eye disease and knowledge about resources.
Nearly 85% of survey respondents reported their institution is equipped to serve uninsured patients, 不讲英语, and people with disabilities. Fifty percent of ophthalmologists and 23% of 验光师 reported having a funding stream for uninsured patients’ care. 然而,, many commented that one of the most significant limiting factors in underserved groups receiving eye care was the lack of patient awareness about how or where they could receive care, coupled with a limited understanding of why they need to receive such care.
“The need for better collaboration among willing providers and communicating with patients are key takeaways,科隆说。. “We’re moving forward with new knowledge.”
Talboys says the findings “will help us advance a public health model for 愿景 health in Utah, 在放映, 健康教育, and linking people to needed services become an integral part of the overall approach.”
下一个步骤
In response to the survey, the ARCHES group is making plans to:
- Create a referral network to connect patients with eye care providers and community clinics in an easy-to-access online format.
- Increase the number of 验光师 in the referral network.
- Use teleophthalmology for remote patient consultations.
- Conduct community focus groups and interviews to refine the list of needs and priorities.
- Distribute educational materials to patients that explain the basics of eye diseases, 眼部护理和安全, and the need for regular dilated eye exams.
- Create 研究 projects to address priorities identified in the survey.