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  Vol. 115 No. 4, April 1997 TABLE OF CONTENTS
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Do we understand the effects of 'managed care' in ophthalmology? A review and analysis

S. Asch, C. L. Goldzweig and P. Lee
Health Sciences Program, RAND, Santa Monica, Calif, USA.

Little has been published that directly assesses the effect of structures for providing managed care or the effects of capitated, prepaid financing on the cost and quality of eye care services. Managed care organizations use fewer ophthalmologists and may provide more screening for diabetic retinopathy. Studies of nonophthalmologic care show lower patient satisfaction with care, and mixed effects on cost, quality of care, and access to care, but are difficult to generalize to eye care. We reviewed the published peer-reviewed literature about this topic. Notable gaps exist in the knowledge of critical elements of the influence of managed care on providing eye care and on patient outcomes. Existing measures of quality, cost, satisfaction, and access could easily be adapted for use in evaluating the influence of managed care and guiding health care policy.

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Need for Eye Care Among Older Adults With Diabetes Mellitus in Fee-for-Service and Managed Medicare
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Arch Ophthalmol 2005;123:669-675.
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Assessing Quality and Utilization Patterns in Health Care Delivery Systems
Lee
Arch Ophthalmol 1998;116:234-235.
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