Sensory Health and Universal Health Coverage in Canada—An Environmental Scan
Abstract
:1. Introduction
- What is Canada’s current provision of hearing and vision care under the universal healthcare system at the federal, provincial, and territorial levels?
- What are the gaps/challenges in the care system in meeting the WHO recommendations on vision and ear health in Canada?
2. Methods
- Review and Analysis of Publicly Available Materials: Examination of official documents, reports, and policies related to eye and ear care at various governmental levels.
- Literature Search: Utilization of published literature searches from five scientific databases and a gray literature review of federal, provincial, and territorial governments and non-profit organization websites from April to October 2022.
- Description of Provincial and Territorial Sensory Care Services: Overview of services available in each province and territory, including utilization levels and the burden of sensory care expenses, particularly out-of-pocket costs.
3. Results
3.1. Study Characteristics
3.2. Vision and Hearing Care Services in Canada—Federal, Provincial, and Territorial Provision
3.3. Gaps in Vision and Hearing Services in Canada
3.4. Individual User Level
3.5. Service Provider Level
3.6. System Level
3.7. Provincial and Territorial Scan
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- WFDB Global Report 2018—WFDB. Available online: https://wfdb.eu/wfdb-report-2018/ (accessed on 22 September 2024).
- Canadian Association of Optometrists. CAO Eye Health Statistics. Available online: https://opto.ca/sites/default/files/resources/documents/eye_health_statistics_with_references_july_2019.pdf (accessed on 22 September 2024).
- WFDB Global Report 2023—WFDB. Available online: https://wfdb.eu/wfdb-report-2022/ (accessed on 22 September 2024).
- World Report on Hearing. 3 March 2021. Available online: https://www.who.int/publications-detail-redirect/9789240020481 (accessed on 21 January 2024).
- World Report on Vision. 8 October 2018. Available online: https://www.who.int/publications-detail-redirect/9789241516570 (accessed on 21 January 2024).
- Osoro, A.A.; Atitwa, E.B.; Moturi, J.K. Universal Health Coverage. World J. Soc. Sci. Res. 2020, 7, 14. [Google Scholar] [CrossRef]
- Registered Nurses’ Association of Ontario. Coming Together, Moving Forward: Building the Next Chapter of Ontario’s Rural, Remote, & Northern Nursing Workforce Report; Registered Nurses’ Association of Ontario: Toronto, ON, Canada, 2015. [Google Scholar]
- Shahid, M.; Turin, T.C. Conducting Comprehensive Environmental Scans in Health Research: A Process for Assessing the Subject Matter Landscape. J. Biomed. Anal. 2018, 1, 71–80. [Google Scholar] [CrossRef]
- Charlton, P.; Kean, T.; Liu, R.H.; Nagel, D.A.; Azar, R.; Doucet, S.; Luke, A.; Montelpare, W.; Mears, K.; Boulos, L. Use of environmental scans in health services delivery research: A scoping review. BMJ Open 2021, 11, e050284. [Google Scholar] [CrossRef] [PubMed]
- Braun, V.; Clarke, V. Using thematic analysis in psychology. Qual. Res. Psychol. 2006, 3, 77–101. [Google Scholar] [CrossRef]
- Canada, H. Canada Health Act. 26 July 2004. Available online: https://www.canada.ca/en/health-canada/services/health-care-system/canada-health-care-system-medicare/canada-health-act.html (accessed on 12 November 2024).
- Health Canada. The Non-Insured Health Benefits (NIHB) Program Eye and Vision Care Benefit Information. Available online: https://www.canada.ca/content/dam/hc-sc/migration/hc-sc/fniah-spnia/alt_formats/pdf/nihb-ssna/benefit-prestation/eye-yeux/eye-yeux-eng.pdf (accessed on 12 November 2024).
- Health Canada. Supplemental Health Care. 18 July 2024. Available online: https://www.canada.ca/en/department-national-defence/services/benefits-military/pay-pension-benefits/benefits/medical-dental/supplemental-health-care.html (accessed on 12 November 2024).
- Hearing Loss and Tinnitus|Veterans Affairs Canada. Available online: https://www.veterans.gc.ca/en/mental-and-physical-health/hearing-loss-and-tinnitus (accessed on 12 November 2024).
- Mobile Eye Clinic—Canadian Council of the Blind. 13 September 2023. Available online: https://ccbnational.net/shaggy/mobile-eye-clinic/ (accessed on 12 November 2024).
- Government of Canada. Non-Insured Health Benefits Program Updates. 3 January 2020. Available online: https://www.sac-isc.gc.ca/eng/1578079214611/1578079236012 (accessed on 21 January 2024).
- What OHIP Covers|ontario.ca. Available online: http://www.ontario.ca/page/what-ohip-covers (accessed on 12 November 2024).
- Rezoana, Z. The Latest on the Save Eye Care Campaign. Ontario Association of Optometrists. 14 July 2021. Available online: https://optom.on.ca/blog-saveeyecarecampaign/ (accessed on 12 November 2024).
- Hearing Devices|ontario.ca. Available online: http://www.ontario.ca/page/hearing-devices (accessed on 12 November 2024).
- Infant Hearing Program|ontario.ca. Available online: http://www.ontario.ca/page/infant-hearing-program (accessed on 12 November 2024).
- Optometric Services|Régie de L’assurance Maladie du Québec (RAMQ). Available online: https://www.ramq.gouv.qc.ca/en/citizens/health-insurance/optometric-services (accessed on 12 November 2024).
- Eyeglasses and Contact Lenses for Children|Régie de L’assurance Maladie du Québec (RAMQ). Available online: https://www.ramq.gouv.qc.ca/en/citizens/aid-programs/eyeglasses-contact-lenses-children (accessed on 12 November 2024).
- Quebec Health Insurance Board. Hearing Aids|Régie de L’assurance Maladie du Québec (RAMQ). 2020. Available online: https://www.ramq.gouv.qc.ca/en/citizens/aid-programs/hearing-aids (accessed on 22 September 2024).
- Manitoba Health Card and Coverage. Province of Manitoba—Health. Available online: https://www.gov.mb.ca/health/mhsip/ (accessed on 12 November 2024).
- Province of Manitoba|Better Health. Province of Manitoba. Available online: https://www.gov.mb.ca/betterhealth/health_services/vision.html (accessed on 12 November 2024).
- Manitoba Education and Training Inclusion Support Branch. Vision Screening in Manitoba Schools: Directions for Kindergarten, Grades 1, 3, 5, 7, 9, 11. 2019. Available online: https://www.edu.gov.mb.ca/k12/specedu/blind/viscreening/vision_screening_manual.pdf (accessed on 12 November 2024).
- Government of Manitoba E. Manitoba Education and Early Childhood Learning. Available online: https://www.edu.gov.mb.ca/k12/specedu/blind/viscreening/index.html (accessed on 12 November 2024).
- Province of Manitoba|Health, Seniors and Long-Term Care. Province of Manitoba. Available online: https://www.gov.mb.ca/seniors/hearing_aid_program.html (accessed on 12 November 2024).
- Partially Covered Services in Saskatchewan|Health Benefits Coverage. Government of Saskatchewan. Available online: https://www.saskatchewan.ca/residents/health/prescription-drug-plans-and-health-coverage/health-benefits-coverage/partially-covered-services (accessed on 12 November 2024).
- Provincial Vision Coverage in Saskatchewan. Campus Vision. Available online: https://campusvision.com/insurance/provincial-coverage/saskatchewan/ (accessed on 12 November 2024).
- Audiology and Hearing Services|Accessing Health Care Services in Saskatchewan. Government of Saskatchewan. Available online: https://www.saskatchewan.ca/residents/health/accessing-health-care-services/audiology-and-hearing-services (accessed on 12 November 2024).
- Health Care Services Covered in Alberta|Alberta.ca. 7 November 2024. Available online: https://www.alberta.ca/ahcip-what-is-covered (accessed on 12 November 2024).
- AADL—Benefits Covered|Alberta.ca. 7 November 2024. Available online: https://www.alberta.ca/aadl-benefits-covered (accessed on 12 November 2024).
- Alberta Newborn Screening Program|Alberta.ca. 7 November 2024. Available online: https://www.alberta.ca/newborn-metabolic-screening (accessed on 12 November 2024).
- Reduction M of SD and P. Optical Services—Province of British Columbia. Available online: https://www2.gov.bc.ca/gov/content/governments/policies-for-government/bcea-policy-and-procedure-manual/health-supplements-and-programs/optical-services (accessed on 12 November 2024).
- Government of British Columbia. Optical Coverage—Province of British Columbia. Available online: https://www2.gov.bc.ca/gov/content/family-social-supports/income-assistance/on-assistance/supplements/optical (accessed on 12 November 2024).
- Government of British Columbia. Early Childhood Health and Screening Programs. 28 June 2022. Available online: https://www2.gov.bc.ca/gov/content/health/managing-your-health/family/early-childhood-health-and-screening-programs (accessed on 12 November 2024).
- Health M of Services Not Covered by the Medical Services Plan (MSP)—Province of British Columbia. Available online: https://www2.gov.bc.ca/gov/content/health/health-drug-coverage/msp/bc-residents/benefits/services-not-covered-by-msp (accessed on 12 November 2024).
- BC Early Hearing Program. Available online: http://www.phsa.ca/our-services/programs-services/bc-early-hearing-program (accessed on 12 November 2024).
- Health Related Services. Children, Seniors and Social Development. Available online: https://www.gov.nl.ca/cssd/income-support/healthservices/ (accessed on 12 November 2024).
- Newfoundland and Labrador Eye See Eye Learn Program. Health and Community Services. Available online: https://www.gov.nl.ca/hcs/childrenyouthfamilies/eye-see-eye-learn/ (accessed on 12 November 2024).
- Extended Health—Medical Insurance. Available online: https://extendedhealthcanada.ca/newfoundland-and-labrador-health-insurance (accessed on 12 November 2024).
- Hospital Insurance Plan. Health and Community Services. Available online: https://www.gov.nl.ca/hcs/mcp/hospitalplan/ (accessed on 12 November 2024).
- Government of New Brunswick C. Healthy Smiles, Clear Vision—Vision Benefit for Four Year Olds. 27 March 2018. Available online: https://www2.gnb.ca/content/gnb/en/corporate/promo/4yr_visionbenefit.html (accessed on 12 November 2024).
- Government of New Brunswick C. Healthy Smiles, Clear Vision. 27 July 2012. Available online: https://www2.gnb.ca/content/gnb/en/departments/social_development/promos/healthy_smiles_clear_vision.html (accessed on 12 November 2024).
- Government of New Brunswick C. Health Services Vision Program. 09:32:06.0. Available online: https://www2.gnb.ca/content/gnb/en/services/services_renderer.7975.Health_Services_Vision_Program_.html (accessed on 12 November 2024).
- Government of New Brunswick C. Health Services Hearing Aid Program. 11:08:34.0. Available online: https://www2.gnb.ca/content/gnb/en/services/services_renderer.8035.Health_Services_Hearing_Aid_Program_.html (accessed on 12 November 2024).
- Government of New Brunswick C. Universal Newborn and Infant Hearing Screening Program. 21 August 2015. Available online: https://www2.gnb.ca/content/gnb/en/departments/health/Hospital-Services/content/Universal-Newborn-and-Infant-Hearing-Screening-Program.html (accessed on 12 November 2024).
- Government of New Brunswick C. Coverage and Claims—Inside New Brunswick. 25 May 2015. Available online: https://www2.gnb.ca/content/gnb/en/departments/health/DrugPlans/content/medicare/CoverageandClaimsInsideNewBrunswick.html (accessed on 12 November 2024).
- Jamie MacDonald. 6.7_vision_and_optical_care_final. 1 December 2022. Available online: https://www.princeedwardisland.ca/sites/default/files/publications/6.7_vision_and_optical_care_final.pdf (accessed on 12 November 2024).
- Health PEI. Eye See...Eye Learn Program. 22 November 2022. Available online: https://www.princeedwardisland.ca/en/information/health-pei/eye-seeeye-learn-program (accessed on 12 November 2024).
- PEI Health WE. Audiology Services. 10 March 2023. Available online: https://www.princeedwardisland.ca/en/service/audiology-services (accessed on 12 November 2024).
- Extended Health—Medical Insurance. Available online: https://extendedhealthcanada.ca/pei-health-insurance (accessed on 12 November 2024).
- Scotia, C.N. Optometry Programs. 20 October 2014. Available online: https://novascotia.ca/dhw/optometry-programs/ (accessed on 12 November 2024).
- Hearing in Children & Newborns|Hearing & Speech Nova Scotia. Available online: https://www.hearingandspeech.ca/our-services/hearing/children-newborns (accessed on 12 November 2024).
- Home|Hearing & Speech Nova Scotia. Available online: https://www.hearingandspeech.ca/ (accessed on 12 November 2024).
- Apply for Extended Health Care Benefits and Pharmacare for Seniors. 26 June 2024. Available online: https://yukon.ca/en/health-and-wellness/care-services/apply-extended-health-care-benefits-and-pharmacare-seniors (accessed on 12 November 2024).
- Get Help to Cover Your Child’s Prescription and Eye-Care Costs. 22 March 2022. Available online: https://yukon.ca/en/health-and-wellness/babies-and-childrens-health/get-help-cover-your-childs-prescription-and-eye-care (accessed on 12 November 2024).
- Government of Northwest Territories. Extended Health Benefits. Available online: https://www.hss.gov.nt.ca/en/services/extended-health-benefits (accessed on 12 November 2024).
- Health and Social Services Authority. NTHSSA Early Hearing Detection and Intervention Program Among Top Grades on National Report Card. Available online: https://www.nthssa.ca/en/newsroom/nthssa-early-hearing-detection-and-intervention-program-among-top-grades-national-report (accessed on 12 November 2024).
- About the Nunavut Health Care Plan|Government of Nunavut. Available online: https://www.gov.nu.ca/en/health/about-nunavut-health-care-plan (accessed on 12 November 2024).
- Extended Health—Medical Insurance. Available online: https://extendedhealthcanada.ca/nunavut-health-insurance (accessed on 12 November 2024).
- Search|Government of Nunavut. Available online: https://www.gov.nu.ca/en/search (accessed on 12 November 2024).
- Department of Health and Wellness of Nova Soctia. Optometric Services Program. 1 August 2024. Available online: https://novascotia.ca/dhw/optometry-programs/Optometry-Guide.pdf (accessed on 22 September 2024).
- Poon, B.; Hertzman, C.; Holley, P.; Louie, A.; De Dios, C.V.; Heard, D.; Hsu, D.; Rayner, A.; Leung, J.W.-S.; Krasnova, A.; et al. BC Early Childhood Vision Screening Program; University of British Columbia: Vancouver, BC, Canada, 2012. [Google Scholar]
- Lu, D.; Birk-Urovitz, E.; Airia, P.; Manson, H.; Tyler, I. Effectiveness of Vision Screening Programs for Children Aged One to Six Years; desLibris: Ottawa, ON, Canada, 2016. [Google Scholar]
- Canadian Infant Hearing Task Force. 2019 Report Card on Canadian Early Hearing Detection and Intervention Programs. 2019. Available online: https://www.sac-oac.ca/wp-content/uploads/2023/02/report_card_canada-2019_en.pdf (accessed on 22 September 2024).
- Government of Yukon. Apply for Extended Health Care Benefits and Pharmacare for Seniors. 7 November 2022. Available online: https://yukon.ca/en/health-and-wellness/care-services/apply-extended-health-care-benefits-and-pharmacare-seniors#pharmacare-benefits (accessed on 21 January 2024).
- Nova Scotia Provincial Health Insurance Plan. September 2020. Available online: https://extendedhealthcanada.ca/nova-scotia-health-insurance (accessed on 21 January 2024).
- Supplementary Health Benefits|Extended Benefits and Drug Plan. Government of Saskatchewan. Available online: https://www.saskatchewan.ca/residents/health/prescription-drug-plans-and-health-coverage/extended-benefits-and-drug-plan/supplementary-health-benefits (accessed on 21 January 2024).
- Hearing Health Alliance of Canada. Towards a National Hearing Health Strategy: An Agenda for Change. 2023. Available online: https://canadianaudiology.ca/wp-content/uploads/2023/03/HHAC_NHHS_Media-Backgrounder_EN_March-1-2023.pdf (accessed on 21 January 2024).
- Bhutta, M.F. Models of service delivery for ear and hearing care in remote or resource-constrained environments. J. Laryngol. Otol. 2019, 133, 39–48. [Google Scholar] [CrossRef]
- Etty, M.C.; Michaelsen, S.; Yelle, B.; Beaulieu, K.; Jacques, P.; Ettaleb, S.; Samaha, D.; Tousignant, B.; Druetz, T. The sociodemographic characteristics and social determinants of visual impairment in a homeless population in the Montreal area. Can. J. Public Health 2023, 114, 113–124. [Google Scholar] [CrossRef]
- Lam, N.; Leat, S. Barriers to accessing low-vision care: The patient’s perspective. Can. J. Ophthalmol. J. Can. D’ophtalmol. 2013, 48, 458–462. [Google Scholar] [CrossRef]
- Ballios, B.G.; Park, T.; Chaudhary, V.; Hurley, B.; Kosar, S.; Sheidow, T.; Cruess, A.; Brent, M.H.; Glazier, R.; Wong, D.T. Identifying gaps in patient access to diabetic screening eye examinations in Ontario: A provincially representative cross-sectional study. Can. J. Ophthalmol. 2021, 56, 223–230. [Google Scholar] [CrossRef]
- Lee, E.Y.; Cui, K.; Trope, G.E.; Buys, Y.M.; Chan, C.H.; Thavorn, K.; Jin, Y.-P. Eye care utilisation in Newfoundland and Labrador: Access barriers and vision health outcomes. Can. J. Ophthalmol. 2018, 53, 342–348. [Google Scholar] [CrossRef]
- Chan, C.H.; Trope, G.E.; Badley, E.M.; Buys, Y.M.; Jin, Y.P. The Impact of Lack of Government-Insured Routine Eye Examinations on the Incidence of Self-Reported Glaucoma, Cataracts, and Vision Loss. Investig. Ophthalmol. Vis. Sci. 2014, 55, 8544–8549. [Google Scholar] [CrossRef]
- Brise, L.S.; de Leeuw, S. Seeing Clearly: A Community-Based Inquiry into Vision Care Access For a Rural Northern First Nation. Can. J. Optom. 2015, 77, 34. [Google Scholar] [CrossRef]
- Yameen, T.A.B.; Abadeh, A.; Lichter, M. Visual impairment and unmet eye care needs among a Syrian pediatric refugee population in a Canadian city. Can. J. Ophthalmol. 2019, 54, 668–673. [Google Scholar] [CrossRef]
- Le, T.D.; Raashid, R.A.; Colpa, L.; Noble, J.; Ali, A.; Wong, A. Paediatric vision screening in the primary care setting in Ontario. Paediatr. Child Health 2018, 23, e33–e39. [Google Scholar] [CrossRef] [PubMed]
- Holliday, H.V.; Jenstad, L.M.; Grosjean, G.; Purves, B. “You Can Lead a Horse to Water …”: Focus Group Perspectives on Initiating and Supporting Hearing Health Change in Older Adults. Am. J. Audiol. 2015, 24, 360–376. [Google Scholar] [CrossRef]
- Moinul, P.; Barbosa, J.; Qian, J.; Chen, M.L.; Mohaghegh, M.; Kaur, H.; Holmes, J.; Radman, H.; Robinson, T.; Chaudhary, V. Does patient education improve compliance to routine diabetic retinopathy screening? J. Telemed. Telecare 2020, 26, 161–173. [Google Scholar] [CrossRef]
- Fitzpatrick, E.M.; McCurdy, L.; Whittingham, J.; Rourke, R.; Nassrallah, F.; Grandpierre, V.; Momoli, F.; Bijelic, V. Hearing loss prevalence and hearing health among school-aged children in the Canadian Arctic. Int. J. Audiol. 2021, 60, 521–531. [Google Scholar] [CrossRef]
- Dawes, P.; Littlejohn, J.; Bott, A.; Brennan, S.; Burrow, S.; Hopper, T.; Scanlan, E. Hearing Assessment and Rehabilitation for People Living with Dementia. Ear Hear. 2022, 43, 1089. [Google Scholar] [CrossRef] [PubMed]
- Asare, A.O.; Wong, A.M.F.; Maurer, D.; Nishimura, M. Access to Vision Services by Vulnerable Populations in Canada: A Scoping Review. J. Health Care Poor Underserved 2019, 30, 6–27. [Google Scholar] [CrossRef]
- Aljied, R.; Aubin, M.J.; Buhrmann, R.; Sabeti, S.; Freeman, E.E. Prevalence and determinants of visual impairment in Canada: Cross-sectional data from the Canadian Longitudinal Study on Aging. Can. J. Ophthalmol. 2018, 53, 291–297. [Google Scholar] [CrossRef]
- Aljied, R.; Aubin, M.J.; Buhrmann, R.; Sabeti, S.; Freeman, E.E. Eye care utilization and its determinants in Canada. Can. J. Ophthalmol. 2018, 53, 298–304. [Google Scholar] [CrossRef]
- Wilson, B.S.; Tucci, D.L.; Merson, M.H.; O’Donoghue, G.M. Global hearing health care: New findings and perspectives. Lancet 2017, 390, 2503–2515. [Google Scholar] [CrossRef] [PubMed]
- Ngo, G.; Trope, G.; Buys, Y.; Jin, Y.P. Significant disparities in eyeglass insurance coverage in Canada. Can. J. Ophthalmol. 2018, 53, 260–265. [Google Scholar] [CrossRef] [PubMed]
- Ostevik, A.V.; Westover, L.; Gynane, H.; Herst, J.; Hodgetts, J.C.; Hodgetts, W.E. Comparison of Health Insurance Coverage for Hearing Aids and Other Services in Alberta. Healthc. Policy 2019, 15. Available online: https://www.longwoods.com/content/26070/healthcare-policy/comparison-of-health-insurance-coverage-for-hearing-aids-and-other-services-in-alberta (accessed on 21 January 2024). [CrossRef] [PubMed]
- Lieu, J.E.C. Speech-Language and Educational Consequences of Unilateral Hearing Loss in Children. Arch. Otolaryngol. Head Neck Surg. 2004, 130, 524–530. [Google Scholar] [CrossRef]
- Martin, D.; Miller, A.P.; Quesnel-Vallée, A.; Caron, N.R.; Vissandjée, B.; Marchildon, G.P. Canada’s universal health-care system: Achieving its potential. Lancet 2018, 391, 1718–1735. [Google Scholar] [CrossRef] [PubMed]
- World Health Organization. World Report on Hearing. 3 March 2021. Available online: https://www.who.int/publications/i/item/9789240020481 (accessed on 22 September 2024).
- World Health Organization. Universal Eye Health: A Global Action Plan 2014-2019; World Health Organization: Geneva, Switzerland, 2013; Available online: https://iris.who.int/handle/10665/105937 (accessed on 22 September 2024).
- World Health Organization Regional Office for South-East. VISION 2020. Report of the Expert Group Meeting, New Delhi, India, 19–20 December 2007. Published Online 2009. Available online: https://iris.who.int/handle/10665/206523 (accessed on 22 September 2024).
- Nicholls, S.G.; Wilson, B.J.; Etchegary, H.; Brehaut, J.C.; Potter, B.K.; Hayeems, R.; Chakraborty, P.; Milburn, J.; Pullman, D.; Turner, L.; et al. Benefits and burdens of newborn screening: Public understanding and decision-making. Per. Med. 2014, 11, 593–607. [Google Scholar] [CrossRef]
- Ayukawa, H.; Roy, A.M. Being Outside of the Box: Audiology in Northern Quebec. 2014. Available online: https://cjslpa.ca/files/2014_CJSLPA_Vol_38/No_02/CJSLPA_Summer_2014_Vol_38_No_2_Paper_6_Ayukawa_Roy.pdf (accessed on 1 December 2024).
- Billard, I. The Hearing and Otitis Program: A model of community based ear and hearing care services for Inuit of Nunavik. Can. J. Speech-Lang. Pathol. Audiol. 2014, 38, 206–217. [Google Scholar]
- Therese Jennissen. Health Issues in Rural Canada. December 1992. Available online: https://publications.gc.ca/Pilot/LoPBdP/BP/bp325-e.htm (accessed on 22 September 2024).
- Bagatto, M.; Fitzpatrick, E.; Kealey, C.; Campbell, B.; Aiken, S. Status of Early Hearing Detection and Intervention Programs in Canada: Results from a Country-Wide Survey. Can. J. Speech-Lang. Pathol. Audiol. 2020, 44. [Google Scholar]
- Montero-Odasso, M.; Montero-Odasso, M.; van der Velde, N.; van der Velde, N.; Martin, F.C.; Martin, F.C.; Petrovic, M.; Petrovic, M.; Tan, M.P.; Tan, M.P.; et al. World guidelines for falls prevention and management for older adults: A global initiative. Age Ageing 2022, 51, afac205. [Google Scholar] [CrossRef]
- Wilson, B.J.; Courage, S.; Bacchus, M.; Dickinson, J.A.; Klarenbach, S.; Garcia, A.J.; Sims-Jones, N.; Thombs, B.D. Screening for impaired vision in community-dwelling adults aged 65 years and older in primary care settings. CMAJ 2018, 190, E588–E594. [Google Scholar] [CrossRef]
- Chadha, S.; Dillard, L.K.; Mariotti, S.P.; Keel, S. Monitoring hearing and vision functions in older adults: Rationale and process. Age Ageing 2023, 52 (Suppl. 4), iv158–iv161. [Google Scholar] [CrossRef] [PubMed]
- Speech-Language & Audiology Canada. Universal Newborn Hearing Screening in Canada. 2010. Available online: https://www.sac-oac.ca/wp-content/uploads/2023/02/SAC-OAC-UNHS-PP_EN.pdf (accessed on 19 November 2024).
Location | Vision Care Coverage | Hearing Care Coverage |
---|---|---|
Canada | Canada Health Act: Does not cover vision care, dental care, prescription drugs, ambulance services, and independent living [11]. Non-Insured Health Benefits Program (NIHB): Covers eye exams and eyeglasses for First Nations/Inuit, Canadian Armed Forces, veterans, RCMP [12,13,14]. The Mobile Eye Clinic initiative brings optometrists to schools, youth centers, colleges/universities, seniors’ residences and community health centers to perform comprehensive eye exams [15]. | Eligibility for hearing aids expanded under non-insured health benefits; coverage varies for veterans, RCMP, etc. [16]. |
Ontario | Ontario Health Insurance Program (OHIP): covers routine eye exams once a year for ages 19 and under; 65+; conditions apply for ages 20–64 with eye disease [17,18]. | Assistive Devices Program: covers hearing aids and equipment (FM systems) for eligible individuals [17,19]. Universal Newborn Hearing Screening [19]. Infant Hearing Program: universal newborn screening and assessment services [20]. |
Quebec | Régie de l’assurance maladie du Québec (RAMQ): covers optometric services for children under 18 and seniors 65+, annually; certain low-income adults are also eligible; excludes eyeglasses, contact lenses, unless under 18 [21]. See Better to Succeed: offers $250 for children’s eyeglasses or contacts [22]. | Hearing Devices Program: covers aids and assistive listening devices for all ages; no universal newborn screening [23]. |
Manitoba | Routine eye exam every 2 years for children under 19 and seniors 65+; coverage for medically necessary exams regardless of age [24]. Seniors’ Eyeglass Program: covers eyeglasses every 3 years [24,25]. Vision Screening in Manitoba Schools: for kindergarteners and children in Grades 1–11 offered in odd school years [26,27]. | Children’s Hearing Aid Program: for residents under 18, covers 1 device per ear every 4 years, reimbursement of 80% for up to $500 per ear for a digital or analog programmable device [27]. Seniors Hearing Aid Program: provides up to $2000 for seniors 65+ [28]. Universal Newborn Hearing Screening [28]. |
Saskatchewan | Annual eye exam for those under 18 and diabetics [29,30]. No coverage for eyewear unless through private or other insurance [30]. Newborn screening does not include vision tests [30]. | Universal newborn hearing screening [31]. Hearing tests and aids partially covered under Family and Supplementary Health Benefits [31]. |
Alberta | Alberta Healthcare Insurance Plan (AHCIP): covers routine eye exams under 18 and seniors 65+; medical eye exams covered for all ages when necessary [32]. No coverage for eyewear or contact lenses for most adults [32]. Newborn screening does not include vision tests [33,34]. | Hearing aids and replacement and repair of hearing aids are covered for those under 18, those between 18 and 24 in full-time post-secondary studies, and low-income seniors [33]. Early Hearing Detection and Intervention Program screens infants by 1 month, diagnoses by 3 months, ensures access to intervention by 6 months [32,34]. |
British Columbia | Routine eye exams for seniors 65+; routine eye exams once every 2 years for adults 19–64 who receive income assistance, disability assistance, or hardship assistance, or if these adults are recipients of Medical Services Only or Transitional Health Services [35]. Children under 19 in families who receive assistance obtain routine eye exams and new eyeglasses [36]. BC Early Childhood Vision Screening for children in kindergarten [37]. | The Medical Services Plan: does not cover hearing aids [38]. BC Early Hearing Program: offers province-wide screening and early intervention, including follow-up hearing assessments and the coordination of early language services and parent support for children with a hearing loss [39]. |
Newfoundland and Labrador | Income Support: covers $55 toward the cost of a routine eye exam and a contribution toward the cost of glasses once every 12 months for children, and once every 36 months, for adults [40]. The Eye See Eye Learn Program offers a free eye exam and 1 free pair of eyeglasses for kindergarten children [41]. | Hearing aids are not covered under the Newfoundland and Labrador Medical Care Plan [42]. Hospital Insurance covers rehabilitation services like audiology [43]. |
New Brunswick | Healthy Smiles, Clear Vision Program: for low-income children covers vision assessments and eyeglasses [44,45]. Non-covered items include eyeglasses, frames, lenses for others [46]. | The Hearing Aid Program: for low-income individuals covers standard hearing aids and repairs [47]. Universal newborn hearing screening [48]. Insured Hospital Services include audiology [49]. |
Prince Edward Island | Social assistance applicants are eligible for exams and eyewear every 2 years. For applicants with diabetic eye disease, glaucoma, macular degeneration, or other eye conditions, more frequent and comprehensive exams may be authorized [50]. Eye See…Eye Learn provides one free eye exam and 1 pair of eyeglasses for kindergarten and pre-kindergarten children [51]. | Hearing aids for clients up to age 21 covered; offers assessments, aid fittings, APD testing for eligible individuals [52,53]. |
Nova Scotia | Optometry plan covers children under 10 and seniors 65+ for routine eye exams every 2 years [54]. Comprehensive exams for children 4–19 referred by the Enhanced Vision Screening Program [54]. | Hearing aids for children up to 21 years old (who are in an educational setting) are provided at wholesale cost through the Atlantic Provinces Special Education Authority (APSEA) [55]. Universal newborn screening [55]. Nova Scotia Hearing and Speech Centers provide services to all ages, with support for hearing aids for children up to 21 in school [56]. |
Yukon | Pharmacare Program: Covers one eye exam, new lenses, and a max contribution of $100 toward frames once every 2 years for seniors 65+ [57]. The Children’s Drug and Optical Program: covers 1 eye exam every 2 years, $200 for eyeglasses every 2 years and contact lenses [58]. Community health nurses conduct school-based vision testing available for children [58]. | Hearing services for children and adults provided through community health nurses, including screening, hearing aid consultation, fittings, and repairs [57]. Pharmacare Program: Seniors 65+ qualify for 1 hearing aid in a 4-year period and repair and adjustment of 1 hearing aid with a 12-month warranty [57]. Universal newborn hearing screening [58]. |
Northwest Territories | Extended Health Benefits for Seniors Program: Provides $300 for a standard prescription or $40 for a high-index prescription every 2 years. Adults over 18 are eligible for vision care benefits every 2 years, and those under 18 are eligible every year. Covered services may include frames, lenses and contact lenses [59]. Annual vision screening for kindergarten children provided by public health units in Yellowknife [60]. | Extended Health Benefits: partially cover hearing aids [59]. Infant hearing screening [59]. |
Nunavut | Nunavut Health Care Plan: does not cover optometric services but it covers eye exams, treatment and operations provided by an ophthalmologist [61]. NIHB covers exams and one pair of glasses every 2 years for adults over 19 and annually for children [62]. Vision screening at kindergarten entry [63]. | Nunavut Health Plan: covers eligible seniors for the full cost of 1 hearing aid every 5 years [63]. Kindergarten health assessments include hearing screening, and developmental screening [63]. |
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Asheber, H.; Minhas, R.; Hatolkar, V.; Jaiswal, A.; Wittich, W. Sensory Health and Universal Health Coverage in Canada—An Environmental Scan. Healthcare 2024, 12, 2475. https://doi.org/10.3390/healthcare12232475
Asheber H, Minhas R, Hatolkar V, Jaiswal A, Wittich W. Sensory Health and Universal Health Coverage in Canada—An Environmental Scan. Healthcare. 2024; 12(23):2475. https://doi.org/10.3390/healthcare12232475
Chicago/Turabian StyleAsheber, Hanna, Renu Minhas, Ved Hatolkar, Atul Jaiswal, and Walter Wittich. 2024. "Sensory Health and Universal Health Coverage in Canada—An Environmental Scan" Healthcare 12, no. 23: 2475. https://doi.org/10.3390/healthcare12232475
APA StyleAsheber, H., Minhas, R., Hatolkar, V., Jaiswal, A., & Wittich, W. (2024). Sensory Health and Universal Health Coverage in Canada—An Environmental Scan. Healthcare, 12(23), 2475. https://doi.org/10.3390/healthcare12232475