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Wendy A. Kirkland, Erica Edell, Carter Kirk, Arthi Venkat; Predicting Office Visit Compliance Under New Health Care Reform For Patients With Glaucoma. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5059.
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The recent health care legislation passed by President Obama aims to provide medical insurance to 45 million Americans who are currently uninsured. Theoretically, universal health coverage might lead to earlier detection of eye diseases such as primary open angle glaucoma (POAG). However, a potential pitfall is the large influx of new patients into an already strained healthcare system. The purpose of this study is to investigate whether insurance status influences office visit compliance in patients with POAG. This data will attempt to predict how the addition of newly insured individuals might affect patient scheduling at the Washington National Eye Center (WNEC) and, perhaps, other medical offices.
A retrospective cohort study with 522 POAG patients seen at the WNEC with missed appointments within a 1 year period from April 1, 2009 to April 30, 2010. Participants were identified by ICD-9 code as having POAG. A computer search was then performed to identify these POAG patients and the following clinical data was collected: patient’s age, gender, date of missed appointment, and insurance coverage. In addition, the overall breakdown of patient insurance coverage at the WNEC was taken into consideration based on the vast majority of individuals over the age of 65 with Medicare coverage. For the year of 2009, 72% of patients seen at the eye clinic were insured with 55% of these patients having Medicare, 20% Medicaid, and 25% with private insurance.
Of the 522 patients included in this study, 44.6% with missed appointments had Medicare. Approximately 19.5% of patients were uninsured and the remaining had Medicaid (19.3%) or other types of private insurance (16.6%). The average age of patients with missed appointment was 66.4 years old and 63% of these patients were female.
Overall, approximately 28% of patients seen at the WNEC had no insurance coverage. Of the 522 patients reviewed with missed appointments, 19.5% of patients lacked insurance coverage, suggesting insurance coverage may not influence office visit compliance. In addition, there was a slightly lower percentage of Medicaid patients with missed appointments (19.3%) compared to the overall percentage of Medicaid patients seen (20%), again suggesting that Medicaid coverage may not influence office visit compliance. Further studies including a more diverse population of patients may be helpful in determing the effect of expanded coverage on office visit compliance.
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