{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T14:20:51Z","timestamp":1780928451394,"version":"3.54.1"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T00:00:00Z","timestamp":1682985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims\/Introduction<\/jats:title><jats:p>Regular screening for diabetic retinopathy is essential. This study aimed to show the process and current situation of diabetic retinopathy screening prescribed by physicians (internists) and ophthalmologists for Japanese patients with diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>This retrospective cohort study used data from the Japanese National Database of Insurance Claims between April 2016 and March 2018. Ophthalmology visits and fundus examinations are defined using specific medical procedure codes. The proportion of ophthalmology visits for patients with diabetic medication and for fundus examination among those who visited ophthalmologists was calculated in the fiscal year 2017. A modified Poisson regression analysis was carried out to identify factors associated with retinopathy screening. Similarly, quality indicators by prefectures were also calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 4,408,585 patients receiving diabetic medications (57.8% men, 14.1% insulin use), 47.4% visited the ophthalmology department and 96.9% of those underwent fundus examination. Regression analysis showed that female sex, older age, insulin use, medical facilities with Japan Diabetes Society certification and large medical facilities were predictors of fundus examination. By prefecture, the ophthalmology consultation rate and the fundus examination ranged 38.5\u201351.0% and 92.1\u201398.7%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Less than half of the patients who were prescribed antidiabetic medication by their physicians visited an ophthalmologist. However, most of the patients who visited an ophthalmologist had a fundus examination carried out. A similar tendency was noted for each prefecture. It is essential to reaffirm the necessity of recommending ophthalmologic examinations to physicians and healthcare professionals who care for patients with diabetes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdi.14018","type":"journal-article","created":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T06:17:14Z","timestamp":1683094634000},"page":"883-892","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Patient referral flow between physician and ophthalmologist visits for diabetic retinopathy screening among Japanese patients with diabetes: A retrospective cross\u2010sectional cohort study using the National Database"],"prefix":"10.1111","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3969-7728","authenticated-orcid":false,"given":"Noriko","family":"Ihana\u2010Sugiyama","sequence":"first","affiliation":[{"name":"Diabetes and Metabolism Information Center, Research Institute National Center for Global Health and Medicine  Tokyo Japan"},{"name":"Department of Diabetes, Endocrinology and Metabolism National Center for Global Health and Medicine Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5391-682X","authenticated-orcid":false,"given":"Takehiro","family":"Sugiyama","sequence":"additional","affiliation":[{"name":"Diabetes and Metabolism Information Center, Research Institute National Center for Global Health and Medicine  Tokyo Japan"},{"name":"Institute for Global Health Policy Research, Bureau of International Health Cooperation National Center for Global Health and Medicine  Tokyo Japan"},{"name":"Health Services Research and Development Center University of Tsukuba  Tsukuba Japan"},{"name":"Department of Health Services Research, Instiute of Medicine University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takao","family":"Hirano","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Shinshu University School of Medicine  Nagano Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5786-9802","authenticated-orcid":false,"given":"Kenjiro","family":"Imai","sequence":"additional","affiliation":[{"name":"Diabetes and Metabolism Information Center, Research Institute National Center for Global Health and Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuru","family":"Ohsugi","sequence":"additional","affiliation":[{"name":"Diabetes and Metabolism Information Center, Research Institute National Center for Global Health and Medicine  Tokyo Japan"},{"name":"Department of Diabetes, Endocrinology and Metabolism National Center for Global Health and Medicine Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Kawasaki","sequence":"additional","affiliation":[{"name":"Division of Public Health, Department of Social Medicine Osaka University Graduate School of Medicine  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshinori","family":"Murata","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Shinshu University School of Medicine  Nagano Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youichiro","family":"Ogura","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Science Nagoya City University Graduate School of Medical Sciences  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohjirou","family":"Ueki","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Endocrinology and Metabolism National Center for Global Health and Medicine Hospital  Tokyo 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