Location
Moultrie, GA
Start Date
8-5-2024 1:00 PM
End Date
8-5-2024 4:00 PM
Embargo Period
7-8-2024
Included in
May 8th, 1:00 PM
May 8th, 4:00 PM
Rural and Urban Differences in Eye Care Among Persons with Diabetes Enrolled in Original Medicare - Georgia, 2019
Moultrie, GA
Comments
Introduction: Diabetes is a chronic disease that affects around 30 million Americans of all ages or about 8.9% of the US population. Uncontrolled diabetes has many comorbidities that include but are not limited to retinopathy, nephropathy, and neuropathy. Approximately 26% of diabetics are diagnosed with diabetic retinopathy which is one of the leading causes of blindness among adults in the US. The American Diabetes Association recommends having a dilated eye exam within 5 years of diagnosis and annually thereafter. Healthcare disparities in rural versus urban areas have been well documented in the literature. Living in a rural residential area has been associated with lower income and access to care and is a potential contributing factor in the prevalence of diabetics that present for eye exams and ultimately diagnosed with diabetic retinopathy.
Objective: The goals of this study are to evaluate the following in Georgia Original Medicare enrollees: describe and compare the prevalence and demographics of persons with diabetes and diabetic retinopathy, describe and compare the prevalence and demographics of eye exam claims in persons with diabetes, and assess the prevalence of eye-care practices in Georgia counties and public health districts as a proxy for access to care.
Methods: A cross-sectional ecological study design was utilized to describe and assess the differences in prevalence rates of diabetes, diabetic retinopathy, and eye exams in Georgia Original Medicare enrollees. Data was extracted from several administrative databases, available online, including but not limited to: the Center for Medicare and Medicaid Services Enrollment Data, the Centers for Disease Control and Prevention (CDC) US Diabetes Surveillance System and the CDC Vision and Eye Health Surveillance System. Prevalence rates were calculated and stratified by gender, race/ethnicity, county, rural vs. urban counties, and public health districts. Estimates of practice locations providing eye care services (ophthalmologists, optometrists, and opticians) by geographic area were derived from online geographical searches utilizing Google.
Results: The state of Georgia has 159 counties with 120 (75.5%) of them classified as rural. In 2019, there were approximately 1.7 million residents enrolled in Medicare with 60% enrolled in original Medicare (fee-for-service). There were 227,900 Georgians with diabetes enrolled in Original Medicare and Medicare claims reveal that 51% had an eye exam, 12% had a stereo fundus exam, and 10% were diagnosed with diabetic retinopathy. County specific data report that the percent of persons with diabetes with claims for eye exams ranged from 37.45% to 60.48%. This study is in the initial stages and further analysis and interpretation are ongoing.