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Delisted routine eye examinations for nonrefractive eye conditions: a comparative analysis.
William Jeon1, Graham E Trope1, Richard H Glazier1
1Institute of Medical Science (Jeon, Trope, Glazier, Brent, Jin) and Department of Ophthalmology and Vision Sciences (Trope, Brent, Buys, Jin), University of Toronto; Department of Family and Community Medicine (Glazier), University of Toronto and St. Michael's Hospital; ICES (Glazier), Toronto, Ont.
Ontario’s delisting of routine eye exams for adults led to increased use of primary care providers (PCPs) for nonrefractive eye conditions. This shift in eye care utilization warrants further investigation into patient outcomes and cost-effectiveness.
Area of Science:
- Health Services Research
- Public Health Policy
- Ophthalmology
Background:
- In 2004, Ontario de-listed routine eye examinations for adults aged 20-64.
- This policy change potentially redirected patients to primary care providers (PCPs) for eye care previously managed by optometrists.
Purpose of the Study:
- To investigate the impact of the 2004 de-listing on the utilization of PCP services for nonrefractive eye conditions among affected Ontarians.
- To assess changes in eye care seeking behavior following the de-listing of optometric services.
Main Methods:
- A comparative analysis of administrative health data from Ontario (2000-2014) was performed.
- Segmented regression analysis was used to assess changes in PCP service utilization for nonrefractive eye conditions before and after 2004.
- The study included individuals without prior optometric or ophthalmologic visits and excluded those with diabetes.
Main Results:
- A significant increase in PCP utilization for nonrefractive ocular diagnoses was observed post-2004 among individuals aged 20-39 (17.8%) and 40-64 (11.6%).
- This corresponds to an estimated increase of 10,690 patients (20-39 years) and 20,682 patients (40-64 years) visiting PCPs for eye conditions.
- Utilization remained stable for individuals aged 65+ and for non-ocular diagnoses across age groups.
Conclusions:
- The de-listing of routine eye exams in Ontario correlated with increased use of primary care providers for nonrefractive eye conditions.
- Further research is needed to evaluate the clinical outcomes and cost-effectiveness of this shift in eye care management.
- Policy-makers should consider the implications of these findings on healthcare delivery and patient access to eye care.
