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澳大利亚针对患有不同眼部疾病人群的普通全科医生转诊途径。

Australian general medical practitioner referral pathways for people with different ocular conditions.

作者信息

Jamous Khalid F, Jalbert Isabelle, Kalloniatis Michael, Boon Mei Ying

机构信息

School of Optometry and Vision Science, University of New South Wales, Kensington, New South Wales, Australia; Department of Ophthalmology, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia.

出版信息

Clin Exp Optom. 2014 Mar;97(2):152-9. doi: 10.1111/cxo.12102. Epub 2013 Aug 15.

Abstract

BACKGROUND

The aim was to obtain an overview of general medical practitioner (GP) referral pathways to ocular health care and allied services for people identified with age-related macular degeneration (AMD), diabetic retinopathy (DR) or glaucoma (GL).

METHODS

A questionnaire was developed to survey GPs in Australia. Questions included demographic information and referral patterns to ocular and health service providers. The survey was posted to 1,050 randomly selected GPs across Australia.

RESULTS

Fifty-eight GPs participated in this study amounting to a 6.5 per cent response rate. Nearly all GPs referred patients to ophthalmologists (AMD: 98 per cent; DR: 98 per cent; GL: 95 per cent). A smaller proportion of GPs also referred to low vision rehabilitation (LVR) services (AMD: 34 per cent; DR: 33 per cent; GL: 22 per cent), optometrists (AMD: 26 per cent; DR: 34 per cent; GL: 31 per cent), or support services (AMD: 17 per cent; DR: 40 per cent; GL: 19 per cent). For the three tested conditions, there were no statistically significant differences in the proportions of GPs, who referred to ophthalmologists (p = 0.43), optometrists (p = 0.48) or to low vision rehabilitation services (p = 0.31). The proportion of GPs who referred to support services was significantly higher for patients diagnosed with DR than AMD or GL (p < 0.05).

CONCLUSION

The majority of GPs referred patients with AMD, DR or GL to ophthalmologists. Fewer GPs considered referrals to optometrists, low vision rehabilitation or support services. General practitioners may need to be more aware about the central role of optometrists in the delivery of primary eye health care. In the interest of optimising eye care, closer working relationships between GPs and optometrists should be fostered.

摘要

背景

本研究旨在概述全科医生(GP)为年龄相关性黄斑变性(AMD)、糖尿病视网膜病变(DR)或青光眼(GL)患者转诊至眼部保健及相关服务机构的途径。

方法

设计了一份问卷对澳大利亚的全科医生进行调查。问题包括人口统计学信息以及转诊至眼科和健康服务提供者的模式。该调查问卷被寄给了澳大利亚随机挑选的1050名全科医生。

结果

58名全科医生参与了本研究,回复率为6.5%。几乎所有全科医生都会将患者转诊至眼科医生处(AMD:98%;DR:98%;GL:95%)。较少比例的全科医生还会转诊至低视力康复(LVR)服务机构(AMD:34%;DR:33%;GL:22%)、验光师处(AMD:26%;DR:34%;GL:31%)或支持服务机构(AMD:17%;DR:40%;GL:19%)。对于这三种被测试的病症,转诊至眼科医生(p = 0.43)、验光师(p = 0.48)或低视力康复服务机构(p = 0.31)的全科医生比例在统计学上无显著差异。被诊断为DR的患者中,转诊至支持服务机构的全科医生比例显著高于AMD或GL患者(p < 0.05)。

结论

大多数全科医生会将AMD、DR或GL患者转诊至眼科医生处。较少有全科医生会考虑转诊至验光师、低视力康复或支持服务机构。全科医生可能需要更加了解验光师在提供初级眼保健服务中的核心作用。为了优化眼部护理,应促进全科医生与验光师之间更紧密的工作关系。

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