This study surveyed and examined 418 patients age 65 and older with type 2 diabetes--311 in a managed care organization, 107 treated on a fee-for-service basis.
FINDINGS: On their dilated eye exams, the researchers found high rates of untreated eye disease42 percent of patients in managed care programs and 28 percent of the subjects in the fee-for-service group needed care within six months for treatable eye conditions. Dr. Arleen Brown, the lead author, noted that "many of the participants who had unmet needs for treatable eye conditions had seen their eye doctor in the previous 12 months. This suggests that there may be a quality problem with the eye care these seniors received.
IMPACT: Recommendations as to the frequency of diabetic eye examinations don't take into account the presence of other age-related eye conditions such as cataracts and glaucoma. This study suggests that more research is needed to identify health care system-level factors that can be changed to improve the management of eye care for older patients, especially those with diabetes.
AUTHORS: Lead researcher is Dr. Arleen Brown, assistant professor of medicine in the division of general internal medicine and health services research, David Geffen School of Medicine at UCLA.
JOURNAL: Archives of Ophthalmology, May issue.
FUNDERS: The Robert Wood Johnson Foundation and the Agency for Health Care Research and Quality.