Federally Qualified Health Centers as a Model to Improve Vision Health: A Systematic Review

Area of Science:

• Ophthalmology
• Public Health
• Health Services Research

Background:

• Eye health disparities disproportionately affect lower-income and minority populations.
• Federally Qualified Health Centers (FQHCs) are key sites for delivering care to these vulnerable groups.

Purpose of the Study:

• To systematically review vision and eye health care at FQHCs.
• To identify barriers to providing eye care within FQHCs.
• To highlight recommendations for reducing vision health disparities through FQHCs.

Main Methods:

• A systematic review of Embase, SCOPUS, and PubMed databases.
• Inclusion of articles on eye/vision health at US FQHCs published from 1965 to 2023.
• Data extraction and collation following PRISMA guidelines.

Main Results:

• Of 423 unique articles, 43 met inclusion criteria.
• Limited on-site vision services (18.3%-29%) at FQHCs, with many relying on referrals.
• Diabetic retinopathy, general eye health, and glaucoma were primary conditions studied.
• Telehealth initiatives showed promise for expanding access.
• Key barriers included lack of clinicians, resource costs, reimbursement issues, patient finances, and insurance navigation.

Conclusions:

• FQHCs are strategically positioned to enhance vision services and promote health equity.
• Addressing identified systemic and patient-level barriers is essential.
• Policy interventions, novel care models, and collaborations are recommended to improve vision health outcomes.