Financial implications of implementing standards of care for diabetic eye disease

This article reviews practical financial issues surrounding the implementation of published standards of care for diabetic patients concerning examination for detection of retinopathy. Issues such as the financial basis of referral patterns and the fear of patient loss are raised. The role of the primary physician in coordinating care is discussed. The strategies of ophthalmic screening at the site of primary care are presented as alternatives to published standards. There is a need for development of low-cost screening for low-risk patient groups. All effective means of detecting retinopathy and implementing sight-saving therapy in a timely manner is cost-effective compared with the cost saved of disability payment alone.