Changes in testing trends among Ontario residents with diabetes, by age group, before and after routine eye exams were delisted from the provincial public insurance plan
| Variable | Age group, yr | |||
|---|---|---|---|---|
| 40–65 | ≥ 65 | |||
| Change in trend 2002–2004, % (95% CI) | Change in trend 2004–2006, % (95% CI) | Change in trend 2002–2004, % (95% CI) | Change in trend 2 004–2006, % (95% CI) | |
| Overall rates of recommended testing* | ||||
| Eye examinations | 1.1 (−1.4 to 3.6) | −8.7 (−11.2 to −6.3) | 0.5 (−1.3 to 2.3) | 0.6 (0.0 to 1.3) |
| Cholesterol† | 3.9 (0.2 to 7.7) | 2.3 (1.0 to 3.6) | 4.2 (3.5 to 4.8) | 2.0 (1.8 to 2.1) |
| HbA1C | 0.6 (−1.1 to 2.4) | 0.8 (0.2 to 1.5) | 2.4 (0.7 to 4.1) | 2.4 (1.86 to 3.0) |
| Rates by provider | ||||
| Optometry visit | 5.5 (−8.7 to 19.6) | −6.5 (−18.1 to 5.1) | 4.6 (3.0 to 6.2) | 3.2 (2.6 to 3.7) |
| Optometry visit, secondary analysis‡ | 4.0 (0.5 to 7.6) | −6.5 (−9.3 to −3.7) | 4.6 (3.0 to 6.2) | 3.2 (2.6 to 3.7) |
| Physician visit only | −4.1 (−9.4 to 1.2) | −2.3 (−4.2 to −0.4) | −4.1 (−7.3 to −0.8) | −2.6 (−3.8 to −1.4) |
| Rates by population subgroup | ||||
| Men | 1.0 (−1.1 to 3.2) | −8.0 (−10.1 to −5.9) | 0.6 (−1.3 to 2.5) | 0.6 (−0.1 to 1.3) |
| Women | 1.2 (−1.9 to 4.4) | −9.6 (−12.7 to −6.6) | 0.5 (−1.2 to 2.2) | 0.6 (0.0 to 1.2) |
| Income quintile | ||||
| 1 (lowest) | 1.0 (−1.2 to 3.2) | −6.9 (−9.1 to −4.8) | 0.6 (−1.7 to 2.8) | 0.5 (−0.3 to 1.3) |
| 2 | 1.7 (−0.4 to 3.8) | −8.6 (−10.6 to −6.5) | 0.3 (−2.0 to 2.6) | 0.7 (−0.1 to 1.5) |
| 3 | 1.1 (−1.0 to 3.2) | −9.2 (−11.2 to −7.2) | 0.6 (−1.4 to 2. 7) | 0.5 (−0.2 to 1.3) |
| 4 | 1.6 (−1.7 to 4.2) | −9.6 (−12.4 to −6.7) | 0.3 (−2.0 to 2.7) | 0.4 (−0.4 to 1.3) |
| 5 (highest) | 1.0 (−2.7 to 4.7) | −10.4 (−14.0 to −6.8) | 0.6 (0.2 to 1.1) | 0.5 (0.4 to 0.7) |
| Residence | ||||
| Major urban | 1.2 (−1.4 to 3.8) | −9.1 (−11.6 to −6.6) | 0.4 (−1.4 to 2.4) | 0.5 (−0.1 to 1.2) |
| Nonmajor urban | 0.9 (−0.7 to 2.6) | −7.8 (−9.4 to −6.2) | 0.8 (−1.0 to 2.6) | 0.7 (0.0 to 1.3) |
| Rural | 1.0 (−2.2 to 4.3) | −7.1 (−10.2 to −3.9) | 0.6 (−1.6 to 2. 9) | 0.6 (−0.2 to 1.5) |
Note: HbA1C = glycated hemoglobin.
↵* Recommendations are for 1 eye examination, 1 cholesterol test and 4 HbA1C tests in 2 years.
↵† Time converted to log scale for rates for people aged ≥ 65 yr to allow approximation of linear trend.
↵‡ Rates for people aged 40–65 yr from 1998 excluded to allow approximation of a linear trend before 2004.