Royal Devon and Exeter Hospital, England, UK.
Eye (Lond). 2009 Feb;23(2):309-13. doi: 10.1038/sj.eye.6703075. Epub 2008 Feb 8.
To compare the quality of referrals and listing rates of direct optometric referrals vs traditional GP referrals for cataract surgery.
A retrospective cohort of 124 patients referred for cataract surgery was identified (62 via optometric pathway and 62 via GP pathway). The quality of the referral was assessed by establishing if it contained adequate information relating to the College of Optometrists' referral framework document. Age, sex, drug history, listing rate, operative rate, and visual acuity (best corrected) at referral and at the postoperative visit were recorded and compared between the two referral pathways using the Fisher's exact test.
Optometric referrals, relative to GP referrals, were more likely to include information relating to objective visual loss (100 vs 87%, P=0.0061) and to counsel the patient (97 vs 18%, P=0.0001). GP referrals, relative to optometric referrals, were more likely to comment on personal circumstances (32 vs 3%, P=0.0001), past medical history (95 vs 68%, P=0.0001), and drug history (94 vs 69%, P=0.0009). Operative rates were higher for the optometric direct referrals relative to GP referrals (87 vs 69%, P=0.0284). There was no difference in the visual acuity before or after surgery between the pathways.
Optometric direct cataract referrals provide better information on objectively measured vision and better delivery of preoperative counselling. Traditional GP referrals contain better medical history, drug information, and details of personal circumstances. Rates of surgery were slightly higher with optometric referrals.
比较直接验光转诊和传统全科医生转诊进行白内障手术的转诊质量和挂号率。
回顾性分析了 124 例转诊接受白内障手术的患者（62 例经验光转诊，62 例经全科医生转诊）。通过评估其是否包含与验光师学院转诊框架文件相关的足够信息来评估转诊质量。记录年龄、性别、药物史、挂号率、手术率以及转诊时和术后的最佳矫正视力，并使用 Fisher 精确检验比较两种转诊途径之间的差异。
与全科医生转诊相比，验光转诊更有可能包含与客观视力丧失（100 例 vs 87%，P=0.0061）和告知患者相关的信息（97 例 vs 18%，P=0.0001）。与验光转诊相比，全科医生转诊更有可能对个人情况（32 例 vs 3%，P=0.0001）、既往病史（95 例 vs 68%，P=0.0001）和药物史（94 例 vs 69%，P=0.0009）发表意见。与全科医生转诊相比，验光转诊的手术率更高（87 例 vs 69%，P=0.0284）。两种途径的手术前后视力均无差异。
直接验光转诊提供了更好的客观视力信息和更好的术前咨询服务。传统的全科医生转诊包含更好的病史、药物信息和个人情况细节。验光转诊的手术率略高。
