Eye care utilization trends in Ontario's public healthcare system: A 20-year population-based study

Theme: Global and public health ophthalmology
What: Global and public health ophthalmology
Part of: Public Health Ophthalmology: The Intersection between Eye Health and the Environment / Ophtalmologie de la santé publique: Santé publique L’intersection entre la santé oculaire et l’environnement
When: 6/2/2024, 11:15 AM - 12:45 PM
Where: Room | Salle 714 B

Abstract

Purpose: To investigate ocular care utilization trends in Ontario's universal health care system from 1997-2019. 

Study Design: Retrospective, population-based study.

Methods: Using physician billing data from the Ontario Health Insurance Plan (OHIP), we calculated annual eye-visits per 100 population from 1997-2019, stratified by age-group, urban/rural residency, emergency/non-emergency visit, and physician specialty. 

Results: In Ontario, non-emergency eye-visits (including revisits) increased by 4.6 million (67%) from 1997 (6.9 million) to 2019 (11.5 million). Per 100 population, the number of non-emergency visits increased by 32% from 58.4 to 76.9. Emergency eye-visits only slightly increased (2.9%, from 135,147 in 1997 to 139,023 in 2019).

Between 1997 and 2019, among individuals with an eye-care visit, the average annual number of visits per patient increased by 63% from 1.9 to 3.1 for non-emergency cases, and emergency cases exhibited little change (1.2-1.4). Excluding revisits, distinct eye patients per 100 population decreased from 32.7 to 26.6 (19%) for non-emergency visits and from 1.8 to 1.4 for emergency visits, from 1997-2019.

Per 100 population, urban residents exhibited a higher rate of non-emergency visits between 1997-2019 compared to rural residents (94.9 urban vs 90.6 rural). In emergency cases, per 100 population, the visit rate among rural patients (2.3) was more than double that of urban patients (1.0) in all study years, except 1997.

Both urban and rural residents in the 20-39 and 40-64 age groups exhibited a substantial decrease in non-emergency OHIP visits to optometrists after 2004 (e.g., 60.5% in 2004 to 25.09% in 2019). Comparatively, visits to ophthalmologists increased over this timeframe (e.g., 17.5% in 2004 to 44.9% in 2019). Trends in ophthalmology and optometry visits for other age groups remained stable, except for Ontarians under 20, where an increase in optometry visits for both rural and urban populations was seen.

Between 1997 and 2019, primary non-emergency diagnoses remained consistent, with myopia and conjunctivitis for age groups under 40, myopia and glaucoma in the 40-64 age group, and cataract and glaucoma in the 65-79 and 80+ age groups. Corneal foreign body and conjunctivitis were the primary emergency diagnoses in all age-groups throughout the study period.

Conclusions: From 1997 and 2019, Ontario saw a 19% reduction rate in non-emergency eye patients, but a 67% increase in the total number of non-emergency eye-visits, likely due to a 63% increase in revisits per patient. Over the 22 years, urban patients had more frequent visits for non-emergency cases compared to rural patients. The visit rate for emergency cases was twice as common in rural patients than urban patients. The most common eye diagnoses in Ontarians showed little change over the study period.

Presenter(s)

Presenting Author: Kiko Zi Yi Huang

Additional Author(s):

Marko Popovic, Department of Ophthalmology and Vision Sciences, University of Toronto

Peng Yan, Department of Ophthalmology and Vision Sciences, University of Toronto

Yvonne Buys, Department of Ophthalmology and Vision Sciences, University of Toronto

Graham Trope, Department of Ophthalmology and Vision Sciences, University of Toronto

Yaping Jin, Department of Ophthalmology and Vision Sciences, University of Toronto

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