Erie Vital Signs

Diabetes: Retinal Eye Exams

Recent Performance

This trend is mixed or inconclusive.

The percentage of commercial patients who got a retinal eye exam fell slightly to 50% in 2013, and was below the national (52%) and state (57%) rates. Medicare patients were stable at 70%, above the national rate (68%) but a bit below the Pennsylvania rate (73%). Medicaid patient participation rose to 53%, but was still below the national (54% and state (58%) rates.

The Basics

This indicator reports the percentage of patients in each category (commercial, Medicare, Medicaid) who got a retinal eye exam, indicating that they are attending to potential problems that can arise from diabetes.

Why is this important?

  • Diabetes can cause a lot of eye problems, including:
    • Damage to the blood vessels, causing blindness (diabetic retinopathy)
    • Clouding in the lens (cataract)
    • High pressure inside the eye that causes nerve damage and blindness (glaucoma)
  • Complications from diabetes are the leading cause of blindness in the U.S. Blood pressure and blood sugar problems damage the blood vessels in your eyes. When they bleed or heal, the process damages the eye.

How is Erie doing?

  • The charts below show the HEDIS® rates of people with diabetes in Erie who got eye exams and are on the right track to keeping their eyes healthy.
  • The higher the numbers, the better Erie is doing. They show people care about their vision and want to make sure they keep it. They also show that they care about their overall health.
  • Erie is lagging behind the Pennsylvania and national benchmarks in all populations.

How can you help Erie do better?

  • If you have diabetes, see your ophthalmologist or optometrist yearly to check for signs of blindness.
  • Encourage people you know with diabetes to have their eyes checked yearly.
  • Ask your doctor the questions below.

What to ask your doctor:

  • Ask your eye doctor to send the results of your visit to your primary care doctor.
  • How does diabetes affect my vision?
  • How can I manage this with other conditions?
  • How can I protect my vision?
  • What symptoms should I look for if I’m experiencing retinopathy?
  • What can I do to treat it if I already have it?
  • How can I learn more?

v Scroll down to view data charts.


HEDIS® Data Sources | HEDIS® References


Private (Commercial) Insurance

Percent of Commercial Patients Who Got a Retinal Eye Exam — higher is better.
Scroll over the graph to see percentages.

Medicare Insurance

Percent of Medicare Patients Who Got a Retinal Eye Exam — higher is better.
Scroll over the graph to see percentages.

Medicaid Insurance

Percent of Medicaid Patients Who Got a Retinal Eye Exam — higher is better.
Scroll over the graph to see percentages.


HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)

The Details

A retinal eye exam is a test to see if you have damage to the light sensing tissues at the back of your eye (retinopathy).

The eye doctor (optometrist or ophthalmologist) makes your pupil wider with eye drops (dilation) and looks inside for clouding (cataracts), abnormal blood vessels, scars, bleeding, nerve damage, and swelling.

Subcategories

This EVS indicator has subcategories for patients with commercial/private insurance, Medicaid, and Medicare.

Peer Areas

The 2011-2013 data are available for Erie, and provide the benchmark for the state of Pennsylvania and the benchmark for the United States.

Frequency

Annual

Source

These data are from the Healthcare Effectiveness Data and Information Set (HEDIS®), which includes data from insurance claims. HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)

Erie County HEDIS data is collected from the three large insurers in Erie County and aggregate numbers are reported. The insurance companies are HealthAmerica, Highmark Blue Cross Blue Shield, and UPMC Health Plan. Peer, state and national HEDIS data came directly from the National Committee for Quality Assurance (NCQA). The data were compiled by the Erie County Department of Health.

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