Purpose: Quality improvement project to improve diabetic retinopathy education and screening in a rural primary care clinic to meet the standard of care. Aims: To improve the delinquency rate of diabetic retinopathy screening. Processes: Participants included those with type 1 and type 2 diabetes ages 18 and up in the rural health clinic. Diabetic retinopathy screening importance education was displayed in the clinic and provided to each applicable patient in the form of a handout. A diabetic eye camera was brought to the rural health primary care clinic to offer more convenient access and free eye exams to clinic patients with diabetes. The project was deemed quality improvement by the IRB. Results: (To be determined after project implementation – results anticipated to be excellent based on the number of patients who are signed up to participate in this day.) There are 486 patients with a diagnosis of diabetes in the clinic. ___ were delinquent in eye exam prior to implementation and ___ were delinquent after. Limitations: Project performed in only one clinic; project leader is employed at the clinic in this study. Conclusions: Implementation of the eye exam day improved the delinquency rate of diabetic retinopathy screening in the clinic and proved to be a valuable means of enhancing patient compliance and satisfaction of routine eye health monitoring in patients with diabetes.

Introduction: Diabetic retinopathy (a diabetes complication that affects eyes) is one of the leading causes of blindness and low vision in the US. More than 90% of vision loss caused by diabetes can be prevented by a routine annual eye examination and early treatment. However, data shows that about half of people with diabetes in the US do not receive the recommended annual eye screening exams, and there is a scarcity of literature assessing the specific role of health insurance. This study aimed to assess if having health insurance had an impact on eye screening. Methods: The nationally representative 2021 Behavioral Risk Factor Surveillance System (BRFSS) was used to examine having an eye exam within the past year among individuals 18 years of age and older who self-reported living with diabetes. Those who reported having some form of health insurance were considered as having access to health insurance and those who reported no, or don’t know or refused or missing responses were considered as having no access to insurance. Meeting the national recommendations of having a dilated eye exam within the past year was the primary outcome of interest. Those who reported having an eye exam within the past year were considered as meeting the recommendations and who reported no, or don’t know or more than one year ago were considered as not having the recommended service. Other independent variables were defined according to the Andersen Model of Healthcare Services Utilization (predisposing factors, enabling factors, need factors, environment, and health behavior. Chi-square analysis and multivariable logistic regression with OR and 95% CI were used to determine the association between eye screening and health insurance adjusting for other covariates. Results and conclusions: Ninety-one percent (91.3%, 53,919) of the adults reported having some form of health insurance, as compared to 8.7%(3,697) who reported having no form of insurance coverage. Approximately 66.2% of the study population had an eye exam at least once within the past year. A higher proportion of adults who had health insurance reported having an eye exam compared to those with no health insurance (68.6 vs. 44.8%; p=0.000). Among those older than 65 years, 73.9% had eye exam as compared to 42.7% among those younger than 35 years (p=$50,000, 71% had eye exam as compared to 59.9% in those earning