DO WE UNDERSTAND THE EFFECTS OF MANAGED CARE IN OPHTHALMOLOGY - A REVIEW AND ANALYSIS

Little has been published that directly assesses the effect of structu res for providing managed care or the effects of capitated, prepaid fi nancing on the cost and quality of eye care services, Managed care org anizations use fewer ophthalmologists and may provide more screening f or diabetic retinopathy, Studies of nonophthalmologic care show lower patient satisfaction with care, and mixed effects on cost, quality of care, and access to care, but are difficult to generalize to eye care. We reviewed the published peer-reviewed literature about this topic, Notable gaps exist in the knowledge of critical elements of the influe nce of managed care on providing eye care and on patient outcomes. Exi sting measures of quality, cost, satisfaction, and access could easily be adapted for use in evaluating the influence of managed care and gu iding health care policy.