Perumal Divya, Niederer Rachael, Raynel Sue, McGhee Charles N J
Department of Communication Disorders, University of Canterbury, Christchurch, New Zealand.
N Z Med J. 2011 Aug 12;124(1340):35-47.
To establish demographics, referral patterns and clinical characteristics of patients attending an emergency eye service within a major public tertiary teaching hospital and to identify possible targets to improve delivery of patient care.
Retrospective study of all patients (N=504) attending an acute eye clinic over a representative 2-week period within Greenlane Clinical Centre, Auckland.
Mean age was 42.4 plus or minus 20.6 years with mean visual acuity of 6/10. Referrals came from: general-practitioners (GP) (26.2%), self-referrals (18.6%), hospital medical-officers (7.4%), accident and emergency clinics (6.6%) and optometrists (2.2%). 39.1% of patients were follow-up reviews. Main presenting symptoms were pain, red eye and reduced vision. Average waiting-time was 119 plus or minus 98 min. Major diagnoses were trauma, uveitis and adenoviral keratoconjunctivitis (AKC). Males were more likely to present with ocular trauma, whereas females were more likely to exhibit uveitis, contact-lens related keratitis and AKC. Outcomes included follow-up (48.2%), referral to speciality ophthalmology care (19.0%), referral to other clinics (5.75%), and discharge (33.7%).
A significant proportion of presentations could have been appropriately referred to outpatient departments or potentially managed by primary healthcare providers. Potential initiatives to manage excessive workload demands might target prevention of ocular trauma, improved contact-lens education, limiting the spread of AKC and improved GP education.
确定一家大型公立三级教学医院急诊眼科服务患者的人口统计学特征、转诊模式和临床特征，并确定改善患者护理服务的可能目标。
对奥克兰格林莱恩临床中心在具有代表性的两周内就诊于急性眼科诊所的所有患者（N = 504）进行回顾性研究。
平均年龄为42.4±20.6岁，平均视力为6/10。转诊来源包括：全科医生（26.2%）、自我转诊（18.6%）、医院医务人员（7.4%）、急诊诊所（6.6%）和验光师（2.2%）。39.1%的患者为随访复查。主要就诊症状为疼痛、眼红和视力下降。平均等待时间为119±98分钟。主要诊断为外伤、葡萄膜炎和腺病毒性角结膜炎（AKC）。男性更易出现眼外伤，而女性更易患葡萄膜炎、与隐形眼镜相关的角膜炎和AKC。结果包括随访（48.2%）、转诊至眼科专科护理（19.0%）、转诊至其他诊所（5.75%）和出院（33.7%）。
很大一部分就诊患者本可适当转诊至门诊部门或由初级医疗服务提供者进行处理。应对工作量过大问题的潜在举措可能包括预防眼外伤、加强隐形眼镜教育、限制AKC传播以及改善全科医生教育。
