Accessibility of ophthalmic healthcare for residents of an offshore island—an example of integrated delivery system

Abstract

BackgroundTo assess the utilization of and satisfaction with ophthalmic healthcare provided by integrated delivery system (IDS) since 2000 and vision-related quality of life (VRQoL) for residents of an offshore island of Taiwan.MethodsFacilitators interviewed residents (age ≥ 50 years) with the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) for VRQoL and a questionnaire on clinical information, ophthalmic care utilization and satisfaction.ResultsA total of 841 participants (response rate 93.4 %, 841/900) completed the questionnaire survey. Mean age was 63.7 (±10. 7) years. The common eye diseases were cataract (44.7 %), dry eye (15.5 %), and glaucoma (8.7 %). Among the participants, 61.0 % sought ophthalmic care under the IDS in the past year and 17.6 % experienced unmet ophthalmic needs in the past 6 months. Satisfaction with ophthalmic care under the IDS was 88.1 %. Determinants of dissatisfaction under the IDS were distance to healthcare facility and VRQoL. Predictors of VRQoL included age, residential area, marital status, occupation, comorbid condition, commercial insurance, household income, cataracts and glaucoma.ConclusionsThe implementation of IDS improves accessibility of ophthalmic care for residents of an offshore island. Geographic proximity to avail healthcare facility and VRQoL affect satisfaction with the IDS.

Relationship between practices of eye protection against solar ultraviolet radiation and cataract in a rural area

“…Matsu Archipelago, a renowned subtropical military stronghold and historic front of Taiwan, lies about 200 kilometers off Taiwan proper by Taiwan Strait. Residents of Nangan accounted for more than 60% population of Matsu, according to national census [19]. During this period annually, local health authority aligns with the Health Promotion Administration launch of a community-based integrated screening project [including slit lamp biomicroscopy (for ocular surface and cataract) and eye fundus examination (for optic disc)] for residents of Matsu.…”

Redefining Health: Implication for Value-Based Healthcare Reform

“…This is supported by the study of Chen, et al who reported their success in delivering ophthalmic care in the Matsu archipelago, Taiwan, as it is a remote archipelago with limited access to healthcare. Using their system, ophthalmologists kept rotating to deliver eye care in a specific duration of time on a shift basis [28]. Thus, the author suggests expanding primary care in value-based healthcare by also utilizing IT and IDS to overcome obstacles in delivering the most efficient healthcare.…”

Redefining Health: Implication for Value-Based Healthcare Reform

“…This is supported by the study of Chen et al who reported their success in delivering ophthalmic care in Matsu archipelago, Taiwan, as it is a remote archipelago with difficult access to health care. Using their system, ophthalmologist kept rotating to deliver eye care in a duration of time in a shift basis [28]. Thus, the author suggests to expand primary care in value-based healthcare by also utilizing IT and IDS to overcome obstacles in delivering the most efficient healthcare Studies indicate there is discrepancy between the poor and the rich to obtain good quality health care.…”