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

ObjectiveTo 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 providersDesignCross-sectional studySetting19 elderly community centersParticipants1176 people, aged 65 years or above, and 389 optometristsPrimary and secondary outcome measuresUsage characteristics of optometry services by eligible service users of the voucher schemePerspectives of eligible service users on access barriers to optometry servicesPerspectives of service providers on voucher schemeResultsIn 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.ConclusionThe 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 SummaryStrengths 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.