title: Longitudinal rates of annual eye examinations of persons with diabetes and chronic eye diseases.
abstract: OBJECTIVE
  To assess the rate of annual eye examinations over time among older Americans with diabetes and chronic eye diseases.
  
  
  METHODS
  Longitudinal analysis of Medicare claims data.
  
  
  METHODS
  Random sample of Medicare beneficiaries aged 65 years or older.
  
  
  METHODS
  Beneficiaries were followed between 1991 and 1999, unless mortality or enrollment in a health maintenance organization for > 6 months in a given 12-month period intervened. All claims data (both physician and facility) during this time were analyzed for the presence of International Classification of Diseases 9 codes consistent with 1 of the 3 study conditions and the performance of eye examinations.
  
  
  METHODS
  Claims submitted by optometrists, ophthalmologists, or other providers of eye care for subjects with diabetes, glaucoma, or age-related macular degeneration (ARMD). Rates were calculated on the basis of a 15-month time window for annual examinations rather than for 12 months to allow for less than full compliance with the guidelines for various reasons (e.g., bad weather).
  
  
  RESULTS
  Among those with diabetes in this population, 50% to 60% had annual eye examinations in a 15-month period. Of those followed for at least 75 months after diagnosis, about three quarters had one or more 15-month gaps between visits. For subjects diagnosed with glaucoma, most visit rates were in the 70% to 90% range per 15-month period. The percentage of subjects with at least one 15-month period with no visits was considerably lower than for diabetes. The patterns for those with ARMD were in between those for diabetes and glaucoma. Over a nine-year period, only slightly over half of persons with at least one of the study conditions complied with practice guidelines.
  
  
  CONCLUSIONS
  Annual eye examinations for persons diagnosed with diabetes, glaucoma, and ARMD are important for detecting potentially treatable vision loss among those already diagnosed with these conditions. Currently, actual rates of eye examinations for persons diagnosed with the study conditions fall far short of recommended rates. As such, approaches to enhancing longitudinal follow-up of those already in the eye care system are needed.
authors.affiliation: Department of Ophthalmology, Duke University School of Medicine, Durham, NC 27708, USA.
authors.forename: Paul P
authors.initials: PP
authors.lastname: Lee
authors.forename: Zachary W
authors.initials: ZW
authors.lastname: Feldman
authors.forename: Jan
authors.initials: J
authors.lastname: Ostermann
authors.forename: Derek S
authors.initials: DS
authors.lastname: Brown
authors.forename: Frank A
authors.initials: FA
authors.lastname: Sloan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000517:prevention & control*; D003941:Diagnostic Techniques, Ophthalmological / Q000706:statistics & numerical data*; D005901:Glaucoma / Q000175:diagnosis / Q000517:prevention & control*; D019538:Health Care Surveys; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008268:Macular Degeneration / Q000175:diagnosis / Q000517:prevention & control*; D006278:Medicare / Q000706:statistics & numerical data; D014481:United States