Expanded optometric scope for laser shows no impact on driving time, access to care
Click Here to Manage Email Alerts
Key takeaways:
- Drive time to receive laser procedures from optometrists was not found to be shorter.
- There is insufficient evidence to prove that optometric scope expansion leads to improved geographical access to care.
Expansion of optometric scope of practice does not improve geographical access or decrease driving time for laser procedures, according to a study published in JAMA Ophthalmology.
Several states have expanded optometrists’ scope of practice, allowing them to perform laser procedures. The main reason was to increase access to care by reducing distance and driving time.
Image: Adobe Stock
The study used Medicare data from 2016 to 2020 of patients accessing first visits or laser eye care from optometrists or ophthalmologists in Oklahoma, Kentucky, Louisiana, Arkansas and Missouri. Laser procedures included laser peripheral iridotomy, selective laser trabeculoplasty and YAG laser capsulotomy. The total cohort consisted of 1,564,307 individuals. Road geometries and historical traffic data were accessed using mapping and location technologies.
Most of the optometrists performing laser procedures were found to practice in areas already served by ophthalmologists, and only in a few cases (less than 5%) were optometrists the only available source of care at a near distance, within 30 minutes.
Patients on average drove longer to have procedures performed by optometrists. In Kentucky, the shortest median drive time for an optometrist-performed YAG was 49 minutes, while the longest median drive time for an ophthalmologist-performed YAG was 22.8 minutes. In Arkansas, the difference was between 90 minutes and 26.5 minutes for optometrists and ophthalmologists, respectively.
From these data, the authors inferred that “health care professional proximity alone does not determine where a patient decides to receive care.” They expressed concern that patients may be “referred to distant health care professionals within a network, resulting in increased drive times.”
The study, they said, found “insufficient” evidence in support of the argument that expanded optometric scope of practice for laser procedures is beneficial to patients in terms of reduced driving time, with consequent increase in geographical access.
“Given concerns about quality of care per previous literature and the lack of evidence for improved access to care in our study, careful consideration should be given before supporting additional scope of practice expansion,” they said.
Collapse
Read more about
Click Here to Manage Email Alerts