Abstract：
OBJECTIVE: To assess changes in vision care availability at Federally Qualified Health Centers (FQHCs) between 2017 and 2021 and whether neighborhood-level demographic social risk factors (SRFs) associated with eye care services provided by FQHCs.
METHODS: Secondary data analysis of the Health Resources and Services Administration (HRSA) data and 2017-2021 American Community Survey (ACS).
METHODS: Federally Qualified Health Centers.
METHODS: Patient and neighborhood characteristics for SRFs were summarized. Differences in FQHCs providing and not providing vision care were compared via Wilcoxon-Mann-Whitney tests for continuous measures and chi-square tests for categorical measures. Logistic regression models were used to test the associations between neighborhood measures and FQHCs providing vision care, adjusted for patient characteristics.
METHODS: Odds ratios (ORs) with 95% confidence intervals (CIs) for neighborhood-level predictors of FQHCs providing vision care services.
RESULTS: Overall, 28.5% of FQHCs (n = 375/1318) provided vision care in 2017 versus 32% (n = 435/1362) in 2021 with some increases and decreases in both the number of FQHCs and those with and without vision services. Only 2.6% of people who accessed FQHC services received eye care in 2021. Among the 435 FQHCs that provided vision care in 2021, 27.1% (n = 118) had added vision services between 2017 and 2021, 71.5% (n = 311) had been offering vision services since at least 2017, and 1.4% (n = 6) were newly established. FQHCs providing vision care in 2021 were more likely to be in neighborhoods with a higher percentage of Hispanic/Latino individuals (OR, 1.08, 95% CI, 1.02-1.14, P = 0.0094), Medicaid-insured individuals (OR, 1.08, 95% CI, 1.02-1.14, P = 0.0120), and no car households (OR, 1.07, 95% CI, 1.01-1.13, P = 0.0142). However, FQHCs with vision care, compared to FQHCs without vision care, served a lower percentage of Hispanic/Latino individuals (27.2% vs. 33.9%, P = 0.0007), Medicaid-insured patients (42.8% vs. 46.8%, P < 0.0001), and patients living at or below 100% of the federal poverty line (61.3% vs. 66.3%, P < 0.0001).
CONCLUSIONS: Vision care services are available at a few FQHCs, localized to a few states. Expanding eye care access at FQHCs would meet patients where they seek care to mitigate vision loss to underserved communities.
BACKGROUND: Proprietary or commercial disclosure may be found after the references.
METHODS: Secondary data analysis of the Health Resources and Services Administration (HRSA) data and 2017-2021 American Community Survey (ACS).
METHODS: Federally Qualified Health Centers.
METHODS: Patient and neighborhood characteristics for SRFs were summarized. Differences in FQHCs providing and not providing vision care were compared via Wilcoxon-Mann-Whitney tests for continuous measures and chi-square tests for categorical measures. Logistic regression models were used to test the associations between neighborhood measures and FQHCs providing vision care, adjusted for patient characteristics.
METHODS: Odds ratios (ORs) with 95% confidence intervals (CIs) for neighborhood-level predictors of FQHCs providing vision care services.
RESULTS: Overall, 28.5% of FQHCs (n = 375/1318) provided vision care in 2017 versus 32% (n = 435/1362) in 2021 with some increases and decreases in both the number of FQHCs and those with and without vision services. Only 2.6% of people who accessed FQHC services received eye care in 2021. Among the 435 FQHCs that provided vision care in 2021, 27.1% (n = 118) had added vision services between 2017 and 2021, 71.5% (n = 311) had been offering vision services since at least 2017, and 1.4% (n = 6) were newly established. FQHCs providing vision care in 2021 were more likely to be in neighborhoods with a higher percentage of Hispanic/Latino individuals (OR, 1.08, 95% CI, 1.02-1.14, P = 0.0094), Medicaid-insured individuals (OR, 1.08, 95% CI, 1.02-1.14, P = 0.0120), and no car households (OR, 1.07, 95% CI, 1.01-1.13, P = 0.0142). However, FQHCs with vision care, compared to FQHCs without vision care, served a lower percentage of Hispanic/Latino individuals (27.2% vs. 33.9%, P = 0.0007), Medicaid-insured patients (42.8% vs. 46.8%, P < 0.0001), and patients living at or below 100% of the federal poverty line (61.3% vs. 66.3%, P < 0.0001).
CONCLUSIONS: Vision care services are available at a few FQHCs, localized to a few states. Expanding eye care access at FQHCs would meet patients where they seek care to mitigate vision loss to underserved communities.
BACKGROUND: Proprietary or commercial disclosure may be found after the references.
摘要：
目的：了解2017年与2021年联邦合格健康中心（FQHCs）提供的视力护理的可用性，并根据眼部护理服务的可用性评估FQHCs之间在邻里级人口统计学因素和社会风险因素（SRF）方面是否存在差异。
方法：对卫生资源和服务管理局（HRSA）FQHC数据和2017-2021年美国社区调查社区SRF的二级数据分析。
方法：2017年和2021年的FQHCs。
方法：总结了每个SRF的患者和社区特征。通过连续测量的WilcoxonMann-Whitney检验和分类测量的卡方检验，比较了提供和不提供视力护理的FQHC的差异。使用Logistic回归模型来测试邻域测量与提供视力护理的FQHC之间的关联。根据患者特征进行调整。
方法：提供视力保健服务的FQHC的邻域水平预测因子的概率比（OR）和95%置信区间。
结果：总体而言，28.5％的FQHC（n=375/1318）在2017年提供了视力护理，而2021年为32%（n=435/1362），FQHC以及有和没有视力服务的数量都有一些增加和减少。2021年，获得FQHC服务的人中只有2.6％获得了眼科护理。在2021年提供视力保健的435个FQHC中，27.1%(n=118)在2017年至2021年期间增加了视力服务，71.5%(n=311)至少自2017年以来一直提供视力服务，1.4%是新成立的。Logistic回归模型表明，2021年提供视力护理的FQHC更有可能在西班牙裔/拉丁裔个体比例较高的社区（OR=1.08，95％CI=1.02-1.14，p=0.0094），医疗补助保险个人(OR=1.08，95%CI=1.02-1.14，p=0.0120)，无汽车家庭(OR=1.07，95%CI=1.01-1.13，p=0.0142)。然而,具有视力护理的FQHC，与没有视力护理的FQHC相比，服务于西班牙裔/拉丁美洲人的比例较低(27.2%与33.9%,p=0.0007),医疗补助保险患者（42.8%与46.8%,p<0.0001),和生活在/低于联邦贫困线100%的患者(61.3%vs.66.3%,p<0.0001)。
结论：少数FQHC提供视力护理服务，局限于几个州。在FQHC扩大获得眼部护理的机会将满足他们寻求护理的患者，以减轻对服务不足的社区的视力丧失。
方法：对卫生资源和服务管理局（HRSA）FQHC数据和2017-2021年美国社区调查社区SRF的二级数据分析。
方法：2017年和2021年的FQHCs。
方法：总结了每个SRF的患者和社区特征。通过连续测量的WilcoxonMann-Whitney检验和分类测量的卡方检验，比较了提供和不提供视力护理的FQHC的差异。使用Logistic回归模型来测试邻域测量与提供视力护理的FQHC之间的关联。根据患者特征进行调整。
方法：提供视力保健服务的FQHC的邻域水平预测因子的概率比（OR）和95%置信区间。
结果：总体而言，28.5％的FQHC（n=375/1318）在2017年提供了视力护理，而2021年为32%（n=435/1362），FQHC以及有和没有视力服务的数量都有一些增加和减少。2021年，获得FQHC服务的人中只有2.6％获得了眼科护理。在2021年提供视力保健的435个FQHC中，27.1%(n=118)在2017年至2021年期间增加了视力服务，71.5%(n=311)至少自2017年以来一直提供视力服务，1.4%是新成立的。Logistic回归模型表明，2021年提供视力护理的FQHC更有可能在西班牙裔/拉丁裔个体比例较高的社区（OR=1.08，95％CI=1.02-1.14，p=0.0094），医疗补助保险个人(OR=1.08，95%CI=1.02-1.14，p=0.0120)，无汽车家庭(OR=1.07，95%CI=1.01-1.13，p=0.0142)。然而,具有视力护理的FQHC，与没有视力护理的FQHC相比，服务于西班牙裔/拉丁美洲人的比例较低(27.2%与33.9%,p=0.0007),医疗补助保险患者（42.8%与46.8%,p<0.0001),和生活在/低于联邦贫困线100%的患者(61.3%vs.66.3%,p<0.0001)。
结论：少数FQHC提供视力护理服务，局限于几个州。在FQHC扩大获得眼部护理的机会将满足他们寻求护理的患者，以减轻对服务不足的社区的视力丧失。
