Does a non-targeted publicly-funded health care voucher system for the elderly improve access to optometry services?

ABSTRACT Objective To study how a non-targeted publicly-funded health care voucher system for the elderly impact on access to optometry services from the perspective of service users and service providers Design Cross-sectional study Setting 19 elderly community centers Participants 1176 people, aged 65 years or above, and 389 optometrists Primary and secondary outcome measures Usage characteristics of optometry services by eligible service users of the voucher scheme Perspectives of eligible service users on access barriers to optometry services Perspectives of service providers on voucher scheme Results In total, 1156 valid questionnaires were collected from a cohort of eligible service users. Results showed that 53.7% of subjects had used optometry services within the past 2 years, while 22% had not used optometry services before. Lack of familiarity with services provided, professional fees and prices of prescription spectacles were the main barriers to using optometry services. Of those subjects who had used the voucher for optometry service before, 80.4% had eye examination in the past 2 years, versus 64.1% among subjects who had not use health care voucher on the optometry service. “Insufficient voucher value” was a commonly quoted reason for not using the health care vouchers for optometry services. Over 80% of optometrists agreed that the voucher scheme improved the awareness of major eye conditions and enabled the elderly to have prescription spectacles when necessary. Conclusion The health care voucher for the elderly improved access to optometry services. Access could be improved further by promoting awareness optometry services, location of service providers, price transparency of professional services and prescription spectacles. Responses from optometry services providers are supportive of the view that the voucher scheme improved access to and utilization of preventive care services. Article Summary Strengths and limitations of this study - High representativeness of community dwelling older population in Hong Kong. - The mixed method approach provided a more in-depth investigation of the population. - One limitation is the generalizability of the results with older people who are members in the community centers.