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Yaping Jin, Richard Wedge, Anam Khan, Yvonne M Buys, Sherif El-Defrawy, Qishen Chen, Graham Eric Trope; Eye health care delivery on Prince Edward Island: Does public funding policy alter unequal diagnosis by geographic residence?. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5573.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate geographic patterns of eye health care delivery on Prince Edward Island (PEI).
We analyzed PEI physician billing data from 2010-2012 in five areas defined by postal codes (Charlottetown, Summerside, Prince, Queens & Kings and Stratford). Examined eye conditions (glaucoma, cataracts and diabetes) were identified by related ICD-9 codes. Provincial-insured eye care services were recognized using specialty codes. Postal codes were used to determine patient residential location and place of eye care provider's office. Age-standardized rates were computed for comparisons.
During the study period there were 6 ophthalmologists practicing on PEI, 5 (83%) with offices in Charlottetown. There were 20 optometrists practicing on the island with offices across the province. Stratford is closest and Prince farthest from Charlottetown. Optometric services were not government-insured during the study period. To receive provincially-insured eye care services, 54% of islanders residing outside the Greater Charlottetown Area have to travel to Charlottetown. The prevalence of glaucoma visits per 100 people aged 40+ was higher in Charlottetown (6.10) and Stratford (6.38) and lower in the other areas with the lowest in Prince (3.85, p<0.05). A similar pattern was seen with the prevalence of cataract visits. Utilization of ophthalmologists per 100 people was also higher in Charlottetown (10.44) and Stratford (10.90) and lower in the other areas (7.74-8.92, p<0.05). The prevalence of diabetes visits per 100 people was higher in Prince (6.93) and Summerside (6.65) and lower in the other areas (5.44-6.10, p<0.05). However, the utilization of eye care services per 1000 diabetics in Charlottetown (6.58) and Stratford (6.69) was twice the utilization rate in Prince (3.05, p<0.05).
Significantly higher utilization of ophthalmologists and higher prevalence of eye care visits was found in Charlottetown and its closest area Stratford where ophthalmologist offices were highly concentrated, suggesting better patient access and better detection of eye disease in these areas. Encouraging ophthalmologists to work in other areas and/or providing public funding for services by optometrists who work in all areas of PEI may alleviate the observed discrepancy in eye care access and eye disease diagnosis induced by geography.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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