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Comparing geographic access to laser capsulotomy performed by ophthalmologists versus optometrists in the US

Poster Details

First Author: J.Erie USA

Co Author(s):    M. Mahr                    

Abstract Details

Purpose:

Optometrists have had laser capsulotomy privileges in the state of Oklahoma since 1998. Our aim was to quantify differences in Medicare beneficiary proximity to YAG laser capsulotomy-providing ophthalmologists versus optometrists in Oklahoma by using calculated driving distances and times.

Setting:

Mayo Clinic, Rochester, Minnesota, USA

Methods:

2014 Medicare Provider Utilization and Payment 100% and limited 5% datasets from the Centers for Medicare and Medicaid were obtained to identify the office street addresses of Oklahoma ophthalmologists and optometrists who submitted claims to Medicare for a YAG laser capsulotomy, and the county addresses of the corresponding Medicare beneficiaries who received the laser capsulotomy. The shortest travel distances and travel times between the beneficiary and the laser provider were calculated by using Google Maps distance and travel time application programing interfaces.

Results:

In 2014, 90 (57%) of 157 Oklahoma ophthalmologists and 65 (13%) of 506 optometrists submitted 7,521 and 3,751 YAG laser capsulotomy claims to Medicare, respectively. Using the Medicare 5% dataset, there was no difference in driving distance between beneficiaries who received a laser capsulotomy from an ophthalmologist (median 39 miles, Interquartile Range [IQR]; 13 miles, 113 miles) compared to an optometrist (median 46 miles, IQR; 13 miles, 125 miles); P=0.93), and no difference in driving time to an ophthalmologist (median 47 minutes, IQR; 19 minutes, 110 minutes) compared to an optometrist (median 50 minutes, IQR; 17 minutes, 117 minutes, P=0.76).

Conclusions:

Among U.S. Medicare beneficiaries, there was no difference in geographic access to YAG laser capsulotomy performed by an Oklahoma ophthalmologist versus an optometrist as determined by calculated driving distances and times.

Financial Disclosure:

NONE

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