Impact of the COVID-19 pandemic on healthcare access and utilization for American adults who are blind or have low vision

Purpose : The Flatten Inaccessibility survey was administered from April 3 to 13 , 2020 to investigate the experiences of adults with low vision or blindness during the COVID-19 pandemic. Using this data, we aimed to look at characteristics associated with concerns accessing and utilizing healthcare during the pandemic among participants. Methods : Survey questions related to healthcare access and utilization included: (1) getting to a pharmacy for prescriptions, (2) ability to maintain their eyecare regimen, and (3) concerns regarding caregiver access should they be hospitalized for COVID. Responses th of strongly agree or agree were classified as having a concern. Multivariable logistic regression was used to determine the association between demographic characteristics and age of onset of visual impairment (VI) with each concern. Results : 1,921 participants responded to the survey, of whom 65% were blind and 35% had low vision. Table 1 presents demographic characteristics. In regression analysis, females (OR=1.4, 95% CI=1.08-1.74) were more likely to have concerns regarding access to a pharmacy to get prescriptions than males, but no gender differences were noted for maintaining eyecare regimen or caregiver access. As compared to participants with congenital VI, participants with adult-onset VI were more likely (OR=1.8, 95% CI= 1.32-2.45) to report concerns regarding their ability to maintain their eyecare regimen, but no differences were observed for pharmacy or caregiver access. Participants with onset of VI at 2-18 years of age (OR=1.6, 95% CI= 1.16-2.14) and >18 years (OR=1.3, 95% CI= 1.00-1.69) were more likely to report concern regarding access to a caregiver if hospitalized than those who had congenital VI. Participants with additional disabilities were more likely to report concerns across all three healthcare questions (Pharmacy access: OR=1.8, 95% CI= 1.43-2.23;Eyecare regimen: OR=1.7, 95% CI= 1.32-2.23;Caregiver: OR=1.73, 95% CI= 1.39-2.14) compared to those with vision loss only. Conclusions : Our data found that among Americans with low vision or blindness, older adults, females, people with adult onset VI, and multiple disabilities were more likely to report concerns with healthcare access and utilization during the COVID-19 pandemic. This study provides information that may aid policymakers as they shape the pandemic response for people with vision loss.