Eyecare blindspot: patients forego treatment due to rising costs
MEDIA RELEASE: 19 June 2024
Around one-quarter of Australian eyecare patients are avoiding treatment for their condition for cost reasons, according to new research published today.
The study, published in the latest issue of Public Health Research & Practice, a peer-reviewed journal of the Sax Institute, surveyed patients attending collaborative eyecare clinics, where optometrists provide comprehensive diagnostic imaging and eyecare services typical of public hospitals or large private ophthalmology practices. Patients faced significant financial barriers, with 36.8% reporting that they did not obtain services prescribed by an optometrist due to costs. One or more direct or indirect cost barriers were experienced by 42.6% of respondents for optometric eyecare, and 40.4% for specialist eyecare.
Patients with poorer self-rated health or lacking private hospital health insurance were the hardest hit.
“Our findings underline the considerable cost barriers people face when accessing eyecare,” says senior author Dr Angelica Ly, a researcher at the School of Optometry and Vision Science, UNSW Sydney.
“We found that on average, one in four patients were opting not to access eyecare services because of the cost, even after attending a collaborative care clinic that provides services at no cost to patients. And nearly half reported cost as a barrier when seeking eyecare. Our research shows that more support is needed, especially for people with poor self-rated general health or without private hospital health insurance.”
The findings come at a time when the real value of Medicare rebates is in decline, contributing to a considerable uptick in out-of-pocket costs for eyecare services over the past decade, the authors say. The average inflation-adjusted copayment for optometry services increased by over $30 from 2010 to 2020, they note, and the median out-of-pocket fee for specialist services is currently $96. At the same time, use of optometric services is high, with 82% of Australians having undergone an eyecare test in the previous two years.
“Overall, these findings indicate that current collaborative eyecare models may be improved by providing additional support for individuals who are in poorer health or do not have private health insurance. Additionally, public health policies need to use eyecare-specific strategies to optimise access to eyecare,” the authors conclude.
This issue of Public Health Research & Practice also has a strong focus on global health issues, including climate change and refugee health.
A perspective on the recent COP28 climate change conference in Dubai written by researchers from Monash University warns that Australia must phase out fossil fuels, and calls on public health practitioners to take the lead in advocating for climate policies that protect and promote health and equity.
“Integrating health considerations into decision-making and action to address climate change can lead us towards a more sustainable, resilient and equitable future,” they write.
Two other papers address the need for Australia to develop policies to ensure refugees can access necessary catch-up vaccinations to protect their health. Addressing the complexities in the delivery of immunisation to refugees requires a collaborative approach involving policymakers, providers and refugee communities, argues one paper, while the other notes the need for geographically targeted strategies that support primary care access to immunisation for priority populations.
The issue’s editorial, authored by health experts from Monash University and the Burnet Institute, warns that “health investment and action delayed is health and wellbeing delayed”.
“The decision to invest, disinvest or avoid investment in public health, whether in health systems or action on the social, economic, cultural, environmental, commercial and biological determinants of health, has real consequences for people’s physical, emotional, spiritual and mental health and wellbeing,” they write.
The authors note that beyond the challenges of refugee health and climate change highlighted in this issue, there are many other areas of public health where “unrelenting advocacy, greater investment and concerted actions” are needed to make inclusive, fair and equitable societies more achievable.
Please acknowledge Public Health Research & Practice as the source for any stories on our papers. The link to the paper on cost barriers to eyecare is: https://doi.org/10.17061/phrp3422415.
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