Disparities in delivery of ophthalmic care; An exploration of public Medicare data

• DOI: 10.1371/journal.pone.0182598
• Publication Date: 2017-08-07T13:27:00Z
• Authors: Cecilia S. Lee; Grace L. Su; Douglas M. Baughman; Yue Wu; Aaron Y. Lee
• Keywords: Current Procedural Terminology; Cataract extraction; Medicare Part B; Cross-sectional study

Purpose Cataract is a major cause of age-related eye diseases in the United States, and cataract extraction most commonly performed surgery on Medicare beneficiaries. Analyzing pattern delivery care at national level can highlight areas disparities. We evaluated geographic disparities seen to beneficiaries States. Setting extractions across States 2012. Design Cross-sectional study examining distance provider observed versus expected number extractions. Methods current procedural terminology codes were used sum total per surgeon. Epidemiology data surgeries one year by decade life extrapolated via Gaussian Process model. A linear regression model was compare differences between US economic regions. Results 2.2 million patients underwent dataset The average nearest 9.846 miles (standard deviation: 11.410 miles). This statistically significant (p < 2.0 x 10−22) New England (5.935 mi), Mideast (6.356 Great Lakes (8.733 Far West (9.038 Southeast (9.793 Southwest (12.711 Plains (16.047 Rocky Mountain (17.934 mi) greater than 100 surgeon 1,901, where Montana, South Dakota, Texas each had over 200 these distances. Conclusions large discrepancy exists population based factors. Patients who live rural travel farther see ophthalmologists, resulting lower rate surgery. Our results have implications future allocation resources ophthalmologists.