USE OF EYE CARE SERVICES AMONG THE 1991 MEDICARE POPULATION

Purpose: TO determine the use of eye care services by type of provider (ophthalmologist, optometrist, and non-ophthalmologist physician) in the Medicare population. Methods: As a basis for characterizing eye co nditions and ophthalmic services among a population 65 years of age an d older, 1991 claims from a representative 5% sample of Medicare benef iciaries were analyzed using a previously described classification sch eme. Analysis was specifically conducted by type of provider as well a s by the service provided. Results: Almost one half of the approximate ly 30 million Medicare beneficiaries 65 years of age or older received eye care services in 1991, resulting in more than 35,000,000 visits ( caims). Ophthalmologists provided services to 71% of this eye care pop ulation, and optometrists to 22%; 36% of this population received opht halmic-related services from other providers, and 14% from only other providers (commonly for eye lid dermatitis and tumors). Cataract was t he most common condition, accounting for 41% of visits to ophthalmolog ists (and 1.2 million cases of surgery), glaucoma accounted for 19% of visits, and retinal diseases for 14%. The visit percentages for optom etrists are 58%, 8%, and 11%, respectively. Ophthalmic examination and evaluation accounted for 63% of the 28,000,000 paid ophthalmologists' procedures, and 58% of the 5,500,000 optometrists' procedures. Conclu sion: Optometrists and physicians other than ophthalmologists were the sole providers of ophthalmic-related services to a large percentage o f beneficiaries who received eye care in 1991. Within the universe of service provided by ophthalmologists, the majority of all care consist ed of evaluation and management services as opposed to surgical proced ure-based care.