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E-mail: Health@cso.ie Sinead Bracken (+353) 21 453 5485 Caroline Barrett (+353) 21 453 5485

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CSO statistical release, 25 July 2019, 11am

HSE Funded Optical Treatments

2015-2017

Optical treatments and corresponding costs, 2015-2017
	2015	2016	2017
Number of treatments ('000s)	769.7	785.6	699.9
Treatment costs	€29.7m	€30.4m	€27.2m
Average cost per treatment	€38.57	€38.66	€38.78

Number of Optical treatments fall 9% to almost 700,000 between 2015-2017.

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The number of Optical treatments fell from 769.7 thousand to 699.9 thousand between 2015-2017. This is a 9% reduction in the number of treatments. See headline table and Figure 1.

These payments were paid by the Primary Care Reimbursement service (PCRS). Please see background notes for a further description of the PCRS and Community Ophthalmic Services Scheme (COSS). The figures on this release are based off fully complete and processed claims. For this reason, figures may vary from those published by the HSE. Please note, care should be taken when examining trends over time in the form of expenditure and average amounts as eligibility criteria can change over time.

The supply of appliances, such as glasses and contact lenses, are the most popular optical treatment making up over 50% of treatments annually. The second most commonly performed treatment is eye examinations, making up at least 34% of annual optical treatments between 2015-2017. Other treatments, home visits, medical optical treatment, and repairs and replacements make up around 7% of annual treatments between 2015-2017. See Table 1.

Optical treatments are consistently higher among female COSS patients than male COSS patients during the years 2015-2017. Most instances of optical treatments are in the 75 years and over age group. See Table 2a-2e.

In 2017, most treatments including, appliance, bifocal lenses, eye examinations, and single vision lenses to own frame, among other treatments were highest in the Southern Local Health Office Region. However, Bifocals were highest in the West Local Health Office Region. Home visits, repairs and medical optical treatments were highest in Dublin mid-Leinster. See Table 2e.

The average number of treatments per COSS patient in 2015 was 1.14 treatments per COSS patient. In 2017 this figure remained the same. Figures for average treatments per patient are highest in the 75 years and over category. Average number of treatments per patient are highest in the Dublin Mid-Leinster region. See Table 3.

The average number of treatments per COSS patient was 1.07 treatments per patient, between 2015-2017. The state average, and averages for both male and female COSS patients are also 1.07 treatments. Figures for average treatments per patient are highest in the 75 years and over category. Average number of treatments per patient are highest in the Dublin Mid-Leinster region. See Table 4.

Treatments on major optical conditions such as age related macular degeneration, cataracts and glaucoma, have seen an overall increase since 2015 (6%, 5%, 9% respectively). In contrast diabetic ophthalmic management related optical treatments have seen a 40% decrease. Age related macular degeneration treatments are highest in the over 75s category. Treatments for age related macular degeneration, treatments for cataracts and treatments for glaucoma are higher for female COSS patients than male COSS patients. See Table 5.

The average payment for optical average payment per optical treatments increased marginally between 2015 and 2017 (0.6%) and is similar among both COSS patient genders between this time. By 2017, the average payment per female patient was €38.86, and the average payment for male COSS patients was €38.70. The Dublin Mid-Leinster region saw the highest average payments for optical treatments. See Table 6.

Show Table 1 Total Number of Procedures by Treatment Description, 2013-2017 ('000s)

Table 1 Total Number of Procedures by Treatment Description, 2013-2017 ('000s)
Description	2015	2016	2017
Appliances (incl. glasses and contact lenses)	412.4	421.7	380.5
Eye examination	292	297.4	264.5
Home visit by optician/ophthalmologist	10.7	10.9	7.6
Medical optical treatment	26.4	28.1	23.9
Repairs and replacements	28.2	27.5	23.3

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Show Table 2a Percentages of Detailed Optical Treatments, by patient gender, age group and Local Health Office- 2015 ('000s)

Table 2a Percentages of Detailed Optical Treatments, by patient gender, age group and Local Health Office- 2015 ('000s)
			Appliances (incl. glasses and contact lenses)	Eye examination	Home visit by optician/ opthalmologist	Medical optical treatment	Repairs and replacements
State		N	412.4	292	10.7	26.4	28.2
		%	100	100	100	100	100
Gender of patient
	Female	N	240.6	172.8	6.9	16.4	17.5
		%	58.3	59.2	64.4	61.9	61.9
	Male	N	171.8	119.2	3.8	10.1	10.8
		%	41.7	40.8	35.6	38.1	38.1
Age Group
	0 -24	N	30.1	27.7	<0.1	0.3	1.2
		%	7.3	9.5	0.1	1.1	4.4
	25-34	N	17.1	17	<0.1	0.6	0.7
		%	4.2	5.8	0.4	2.2	2.6
	35-44	N	28.5	25.1	0.1	0.9	1.2
		%	6.9	8.6	0.8	3.4	4.3
	45-54	N	59.6	42.3	0.2	1.5	2.9
		%	14.5	14.5	1.9	5.5	10.2
	55-64	N	69.8	45.4	0.5	2.5	3.9
		%	16.9	15.6	4.5	9.4	13.7
	65-74	N	95.8	64.7	1.2	6.2	7.9
		%	23.2	22.2	11.2	23.6	28
	75+	N	111.5	69.8	8.7	14.5	10.4
		%	27	23.9	81.2	54.9	36.8
Local Health Office
	Dublin Mid-Leinster	N	100.8	68.7	3.4	14.5	6
		%	24.5	23.5	32.1	54.8	21.4
	Dublin North East	N	78.5	51.3	2.3	5.8	4.7
		%	19	17.6	21.1	22	16.8
	South	N	120.6	87.8	2.7	3.6	8.7
		%	29.2	30.1	25	13.8	30.7
	West	N	112.5	84.2	2.3	2.5	8.8
		%	27.3	28.8	21.8	9.5	31.2

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Show Table 2b Percentages of Detailed Optical Treatments, by patient gender, age group and Local Health Office - 2016 ('000s)

Table 2b Percentages of Detailed Optical Treatments, by patient gender, age group and Local Health Office - 2016 ('000s)
			Appliances (incl. glasses and contact lenses)	Eye examination	Home visit by optician/ opthalmologist	Medical optical treatment	Repairs and replacements
State		N	421.7	297.4	10.9	28.1	27.5
		%	100	100	100	100	100
Gender of patient
	Female	N	244.7	175.3	7	17.5	17.1
		%	58	58.9	64.4	62.5	61.9
	Male	N	177	122.1	3.9	10.5	10.5
		%	42	41.1	35.6	37.5	38.1
Age Group
	0-24	N	30.1	26.9	<0.1	<0.1	1.2
		%	7.1	9	<0.1	1	4.4
	25-34	N	17.1	16.7	<0.1	0.5	0.7
		%	4.1	5.6	0.4	1.8	2.4
	35-44	N	28.4	24.8	0.1	0.9	1.1
		%	6.7	8.3	0.9	3.1	4
	45-54	N	61.9	43.6	0.2	1.5	2.7
		%	14.7	14.7	1.8	5.5	9.9
	55-64	N	71.3	46.5	0.5	2.6	3.6
		%	16.9	15.6	4.2	9.3	13.1
	65-74	N	100.2	67.4	1.3	6.6	7.8
		%	23.8	22.7	12.2	23.6	28.3
	75+	N	112.8	71.5	8.8	15.6	10.4
		%	26.7	24	80.5	55.7	37.9
Local Health Office
	Dublin Mid-Leinster	N	106.2	71.1	3.5	15.1	5.9
		%	25.2	23.9	32.4	53.8	21.3
	Dublin North East	N	78.5	51.4	2.4	6.6	4.6
		%	18.6	17.3	22.4	23.7	16.8
	South	N	120.1	87.3	2.6	3.7	8.6
		%	28.5	29.4	23.4	13.1	31.1
	West	N	116.8	87.6	2.4	2.6	8.5
		%	27.7	29.4	21.7	9.4	30.7

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Show Table 2c Percentages of Detailed Optical Treatments, by patient gender, age group and Local Health Office - 2017 ('000s)

Table 2c Percentages of Detailed Optical Treatments, by patient gender, age group and Local Health Office - 2017 ('000s)
			Appliances (incl. glasses and contact lenses)	Eye examination	Home visit by optician/ opthalmologist	Medical optical treatment	Repairs and replacements
State
		N	380.5	264.5	7.6	23.9	23.3
		%	100	100	100	100	100
Gender of patient
	Female	N	222.6	157.4	4.9	14.8	14.4
		%	58.5	59.5	64.1	62	61.8
	Male	N	157.9	107.2	2.7	9.1	8.9
		%	41.5	40.5	35.9	38	38.2
Age Group
	0 -24	N	28.3	24.3	0	0.2	1.1
		%	7.5	9.2	0.1	0.9	4.5
	25-34	N	14	13.3	0	0.4	0.5
		%	3.7	5	0.2	1.5	2.2
	35-44	N	24.6	21.3	0.1	0.7	0.8
		%	6.5	8.1	0.7	3	3.6
	45-54	N	54.9	38	0.2	1.4	2.2
		%	14.4	14.4	2.2	5.8	9.5
	55-64	N	64.1	41.1	0.3	2.2	3
		%	16.8	15.5	4.3	9.1	12.7
	65-74	N	91.4	60.7	0.9	6	6.4
		%	24	22.9	11.6	25.1	27.4
	75+	N	103.2	65.8	6.1	13.1	9.3
		%	27.1	24.9	80.9	54.7	39.9
Local Health Office
	Dublin Mid-Leinster	N	93.1	61.9	2.4	12.9	4.9
		%	24.5	23.4	31.2	54.2	21
	Dublin North East	N	68.6	44.4	1.7	5.4	3.9
		%	18	16.8	21.8	22.7	16.7
	South	N	114.8	81.7	2.2	3.9	7.9
		%	30.2	30.9	28.6	16.4	33.7
	West	N	104	76.5	1.4	1.6	6.7
		%	27.3	28.9	18.4	6.7	28.5

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Show Table 3 Average number of treatments per patient by patient gender, age group, and Local Health Office Region, 2015-2017

Table 3 Average number of treatments per patient by patient gender, age group, and Local Health Office Region, 2015-2017
		2015	2016	2017
State
	Total	1.14	1.15	1.14
Gender of patient
	Female	1.14	1.15	1.14
	Male	1.14	1.15	1.14
Age Group
	0 - 24	1.06	1.06	1.05
	25 - 34	1.06	1.06	1.05
	35 - 44	1.07	1.07	1.06
	45 - 54	1.08	1.09	1.08
	55 - 64	1.11	1.12	1.11
	65 - 74	1.17	1.18	1.17
	75+	1.24	1.26	1.24
Local Health Office Region
	Dublin Mid-Leinster	1.21	1.21	1.2
	Dublin North East	1.13	1.14	1.12
	South	1.14	1.15	1.15
	West	1.09	1.11	1.09

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Show Table 4 Number of selected major optical conditions, by patient gender, age group and Local Health Office Region, 2015-2017

Table 4 Number of selected major optical conditions, by patient gender, age group and Local Health Office Region, 2015-2017
			000's of treatments
		Year	Age related mascular degeneration	Cataracts	Diabetic Opthalmic Management	Glaucoma
State
	Total	2015	1.6	3.8	1.5	4.5
		2016	1.7	4.3	1.2	5
		2017	1.7	4	0.9	4.9
Gender of patient
	Female	2015	1.1	2.4	0.7	2.5
		2016	1.1	2.8	0.6	2.7
		2017	1.1	2.6	0.5	2.7
	Male	2015	0.5	1.4	0.8	2.1
		2016	0.5	1.5	0.6	2.3
		2017	0.6	1.5	0.5	2.2
Age Group
	0 - 24	2015	<0.1	<0.1	<0.1	<0.1
		2016	<0.1	<0.1	<0.1	<0.1
		2017	<0.1	<0.1	<0.1	<0.1

	25 - 34	2015	<0.1	<0.1	<0.1	<0.1
		2016	<0.1	<0.1	<0.1	<0.1
		2017	<0.1	<0.1	<0.1	<0.1

	35 - 44	2015	<0.1	<0.1	0.1	0.1
		2016	<0.1	<0.1	<0.1	0.1
		2017	<0.1	<0.1	<0.1	0.1

	45 - 54	2015	<0.1	0.1	0.1	0.3
		2016	<0.1	0.1	0.1	0.3
		2017	0.1	0.1	0.1	0.3

	55 - 64	2015	0.1	0.2	0.3	0.6
		2016	0.1	0.2	0.2	0.6
		2017	0.1	0.2	0.1	0.6

	65 - 74	2015	0.4	1	0.5	1.4
		2016	0.4	1.2	0.4	1.5
		2017	0.4	1.1	0.3	1.5

	75+	2015	1	2.4	0.5	2.1
		2016	1.1	2.7	0.4	2.4
		2017	1	2.6	0.4	2.3
Local Health Office Region
	Dublin Mid-Leinster	2015	1	2.5	0.8	2.4
		2016	1.1	2.7	0.6	2.5
		2017	1	2.6	0.4	2.3

	Dublin North East	2015	0.3	0.6	0.2	1.3
		2016	0.3	0.9	0.2	1.5
		2017	0.3	0.8	0.1	1.4

	South	2015	0.1	0.4	0.3	0.7
		2016	0.2	0.4	0.3	0.8
		2017	0.3	0.4	0.3	1

	West	2015	0.1	0.3	0.2	0.2
		2016	0.1	0.3	0.2	0.3
		2017	0.1	0.2	0.1	0.2

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Show Table 5 Average payment per optical treatment, by patient gender, age group, and Local Health Office Region, 2015-2017

Table 5 Average payment per optical treatment, by patient gender, age group, and Local Health Office Region, 2015-2017
	€
		2015	2016	2017
State
	Total	38.57	38.67	38.8
Gender of patient
	Female	38.6	38.72	38.86
	Male	38.53	38.6	38.7
Age Group
	0 - 24	31.83	31.93	31.95
	25 - 34	32.66	32.7	32.67
	35 - 44	34.42	34.63	34.48
	45 - 54	37.74	37.98	38.05
	55 - 64	39.39	39.38	39.39
	65 - 74	40.8	40.67	40.78
	75+	40.61	40.72	40.96
Local Health Office Region
	Dublin Mid-Leinster	40.21	40.3	40.49
	Dublin North East	38.89	39.25	39.19
	South	37.83	37.71	37.84
	West	37.63	37.77	38.04

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Background Notes

General Medical Services Scheme (GMS):

The data in this release is provided to the Central Statistics Office by the Primary Care Reimbursement Service (PCRS). The PCRS is the part of the Health Service Executive (HSE) that processes payments to all GPs, pharmacists, dentists and other health professionals who provide free or reduced cost services to the public.

Payments to opticians and ophthalmologists are covered under the Community Ophthalmic Services Scheme (COSS). Under the COSS, General Medical Services (GMS) eligible adults have access to a range of treatments and clinical procedures. All claims under the COSS are processed and paid by the PCRS.

Under the GMS, people who are unable without undue hardship to arrange general practitioner medical and surgical services for themselves and their dependants may be granted a medical card and receive free general medical services.

The figures derived in this release refer to claims that were carried out in the corresponding year.

Explanation for differences between published PCRS figures and CSO figures:

Please note, there are some differences between figures presented in this release, and releases composed by the HSE. These figures are not comparable. CSO figures are calculated from a claim records data set, while HSE figures are calculated from a claim record and expenditure data set.

CSO expenditure figures are based solely off complete and fully processed Optical treatments that were carried out .

This data set on which this release is based includes only treatments and costs for treatments for which claims were filled out in full, processed and paid. Claims made to PCRS, were deemed incomplete if they lacked patient information (e.g. gender, DOB) and are not reported in this release. The use of only fully complete claims enables the breakdown of the figures by age group, gender and Local Health Office Region which is a valuable dimension of the data set.

Treatments carried out in one calendar year, but not claimed until the following calendar year do not always appear in this claims data set. Furthermore, claims which are rejected and not processed until the following calendar year do not always appear in this claims data set.

Regions

The regions consist of the local health offices and are constructed as follows;

Local Health Offices
Dublin Mid-Leinster	Dublin South	Dublin North East	Dublin North West
	Dublin South East		Dublin North Central
	Dublin South City		Dublin North City
	Dublin South West		Cavan / Monaghan
	Dublin West		Louth
	Kildare / West Wicklow		Meath
	Wicklow
	Laois / Offaly
	Longford / Westmeath

West	Galway	South	South Lee Cork
	Mayo		North Lee Cork
	Roscommon		West Cork
	Donegal		Kerry
	Sligo / Leitrim		North Cork
	Clare		Carlow / Kilkenny
	North Tipperary / East Limerick		Waterford
	Limerick		South Tipperary
			Wexford

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HSE Funded Optical Treatments

2015-2017

Number of Optical treatments fall 9% to almost 700,000 between 2015-2017.

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