Changes in utilisation of optometry services with a non-targeted publicly-funded health care voucher system

Clinical relevance:
Understanding the impact of a health care voucher scheme and service access
barriers could facilitate optometry service promotion to the older population.

Background:
A voucher is one strategy to improve the utilisation of the different health care services
available in the private sector. This study aims to explore how a health care voucher system for older
people impacts utilisation of optometry services from the perspective of service users and service
providers.

Methods:
People aged 65 years or above were recruited to fill in a structured questionnaire studying
the usage characteristics and access barriers of optometry services and the health care voucher. Views
from the optometrists about the voucher scheme were collected by questionnaire.

Results:
A total of 1156 valid questionnaires from eligible voucher users was collected. Results
showed that 53.7% (621/1156) of participants had used optometry services within the past 2 years.
Lack of familiarity with services provided, professional fees, and prices of spectacles were the main
barriers to using optometry services. Of those participants who had used the voucher for optometry
services previously, 80.4% (284/353) had an eye examination in the past 2 years. Among 389
optometrists who participated in the study, over 80% agreed that the voucher scheme improved
awareness of major eye conditions and access to prescription spectacles when necessary.

Conclusion:
The health care voucher for older people improved access to optometry services. Access
could be further improved by increasing price transparency of professional services and prescription
spectacles. Responses from optometry service providers supported the view that the voucher scheme
improved access to, and utilisation of, preventive care services.