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Can J Ophthalmol. 2016 Dec;51(6):452-458. doi: 10.1016/j.jcjo.2016.05.001. Epub 2016 Oct 1.

Socioeconomic status and utilization of amblyopia services at a tertiary pediatric hospital in Canada.

Author information

1
Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Ont. Electronic address: asharma.w@gmail.com.
2
Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Ont; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont.
3
Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Ont.
4
School of Optometry, University of Waterloo, Waterloo, Ont.
5
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont; Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.

Abstract

OBJECTIVE:

To evaluate whether socioeconomic status is associated with equal utilization of amblyopia services at The Hospital for Sick Children (SickKids), a pediatric tertiary hospital in Canada.

DESIGN:

This is a retrospective, cross-sectional study.

PARTICIPANTS:

The medical records of children aged under 7 years diagnosed with amblyopia at SickKids from 2007 to 2009 were reviewed.

METHODS:

Socioeconomic status was derived from patients' residential postal codes through linking with income data in the 2006 Canadian census report. Patients were divided into 5 income quintiles to compare with amblyopia service utilization. The main outcome measure was the observed distribution of amblyopia patients by socioeconomic status versus the expected distribution of 20% for each quintile.

RESULTS:

The analyses included 336 patients. Children with amblyopia at SickKids were more likely to come from the richest neighbourhood (32.5%), whereas children from each of the 3 lowest quintiles (14.6%-15.5%) were less likely to present at SickKids. These results differed significantly from the expected 20% for each quintile (p < 0.0001). All types of amblyopia were significantly under-represented for children from the lower socioeconomic groups. When analyses were stratified by travel distance to the hospital, a significant inequality between the lower and higher income quintiles remained for nonmetropolitan Toronto patients, but not for metropolitan Toronto patients.

CONCLUSION:

Despite a publicly funded health-care system in Canada, children from lower socioeconomic neighbourhoods in distant areas utilize the amblyopia services in a tertiary pediatric centre less often than those from higher socioeconomic status.

PMID:
27938957
DOI:
10.1016/j.jcjo.2016.05.001
[Indexed for MEDLINE]

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