Assessing financial insecurity among common eye conditions: a 2016–2017 national health survey study

OBJECTIVE: To explore the prevalence and demographics of financial insecurity in individuals with eye disease in the United States. METHODS: This retrospective cross-sectional study analysed questions from the nationally representative 2016–2017 National Health Interview Survey (NHIS) with the eye conditions macular degeneration, diabetic retinopathy, glaucoma, and cataract. Data was analysed as a whole and then further analysed by condition. Evaluated topics indicated financial insecurity such as individuals reporting difficulty paying bills among eye conditions studied and by demographics. RESULTS: Survey responses estimated that the overall prevalence of reporting problems paying or unable to pay bills were 12.49% (95% C.I. 11.62–13.36%) among patients with eye conditions. The overall prevalence of patients delaying care was 6.77% (95% C.I. 6.17–7.36%) and 17.06% (95% C.I. 15.99–18.14%) of individuals with eye conditions reported worrying about housing payments. Multivariable logistic regression revealed that demographics who more frequently had difficulty paying medical bills include individuals age 45–64 (3.33 aOR, C.I. 2.79–3.98, p < 0.001), blacks (1.90 aOR, C.I., 1.48–2.45, p < 0.001), Hispanics (1.51 aOR, C.I. 1.07–2.12, p = 0.020), and those 100–200% of the federal poverty line (2.16 aOR, C.I. 1.76–2.66, p < 0.001) or below the poverty line (1.93 aOR, C.I. 1.48–2.53, p < 0.001). CONCLUSION: There are several demographics with eye disease that self-report financial insecurity. There should be greater concern for financial insecurity among diabetic retinopathy and glaucoma patients. Ophthalmologists should consider engaging in proactive discussions with at-risk patients to reduce potential non-adherence secondary to financial insecurity.