Original articleVision loss among diabetics in a group model health maintenance organization (HMO)
Section snippets
Methods
We studied management of diabetic retinopathy in Kaiser Permanente (KP) Southern California. KP, a group model health maintenance organization, is the largest provider of managed care in Southern California and insures approximately 23% of insured patients. Charts were reviewed for information recorded during the 2 year study period (January 1, 1996 and December 31,1997). The following was recorded: current age, last name, gender, age of onset of diabetes, eye care information (date of last
Results
Our study population was 51.7% male, had a mean age of 60.4 years, a mean duration of diabetes of 9.6 years, and a mean hemoglobin A1c of 8.3% (Table 1). During the study period, 77.5% of patients received a screening eye examination with examination by an ophthalmologist, an optometrist, or review of a retinal photograph. Table 2 describes the mean visual acuity in the better and worse eye. In 1.5% of patients, the visual acuity in the better eye was 20/200 or worse (legally blind), while
Discussion
Evaluating eye care provided by managed care organizations is important because many people are enrolled in these programs. To protect the health of these patients, it is our responsibility to evaluate their care and advocate for them. We chose to study diabetes eye care because intervention has been shown to prevent blindness and also because it has been identified by the National Committee on Quality Assurance (NCQA) as a HEDIS (Health plan Employer Data and Information Set) measure. While
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