Ellwein L B, Friedlin V, McBean A M, Lee P P
National Eye Institute, Bethesda, MD 20892-2510, USA.
Ophthalmology. 1996 Nov;103(11):1732-43. doi: 10.1016/s0161-6420(96)30433-8.
To determine the use of eye care services by type of provider (ophthalmologist, optometrist, and non-ophthalmologist physician) in the Medicare population.
As a basis for characterizing eye conditions and ophthalmic services among a population 65 years of age and older, 1991 claims from a representative 5% sample of Medicare beneficiaries were analyzed using a previously described classification scheme. Analysis was specifically conducted by type of provider as well as by the service provided.
Almost one half of the approximately 30 million Medicare beneficiaries 65 years of age or older received eye care services in 1991, resulting in more than 35,000,000 visits (claims). Ophthalmologists provided services to 71% of this eye care population, and optometrists to 22%; 36% of this population received ophthalmic-related services from other providers, and 14% from only other providers (commonly for eye lid dermatitis and tumors). Cataract was the most common condition, accounting for 41% of visits to ophthalmologists (and 1.2 million cases of surgery), glaucoma accounted for 19% of visits, and retinal diseases for 14%. The visit percentages for optometrists 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.
Optometrists and physicians other than ophthalmologists were the sole providers of ophthalmic-related services to a large percentage of beneficiaries who received eye care in 1991. Within the universe of service provided by ophthalmologists, the majority of all care consisted of evaluation and management services as opposed to surgical procedure-based care.
确定医疗保险人群中不同类型医疗服务提供者（眼科医生、验光师和非眼科医生）提供眼部护理服务的情况。
为了描述65岁及以上人群的眼部疾病和眼科服务情况，我们使用先前描述的分类方案，对来自医疗保险受益人的代表性5%样本的1991份索赔进行了分析。具体分析按医疗服务提供者类型以及所提供的服务进行。
在1991年，约3000万65岁及以上的医疗保险受益人中，近一半接受了眼部护理服务，产生了超过3500万次就诊（索赔）。眼科医生为71%的接受眼部护理的人群提供服务，验光师为22%；36%的人群从其他提供者那里接受了眼科相关服务，14%的人群仅从其他提供者那里接受服务（通常是眼睑皮炎和肿瘤方面）。白内障是最常见的疾病，占眼科医生就诊量的41%（以及120万例手术），青光眼占就诊量的19%，视网膜疾病占14%。验光师的就诊百分比分别为58%、8%和11%。眼科检查和评估占支付的2800万次眼科医生诊疗程序的63%，以及550万次验光师诊疗程序的58%。
验光师和非眼科医生是1991年接受眼部护理的很大一部分受益人的眼科相关服务的唯一提供者。在眼科医生提供的服务范围内，所有护理的大部分包括评估和管理服务，而不是基于手术程序的护理。
