Konstantakopoulou E, Harper R A, Edgar D F, Lawrenson J G
Centre for Public Health Research, School of Health Sciences, City University London, London, UK.
Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
BMJ Open. 2014 May 29;4(5):e004781. doi: 10.1136/bmjopen-2013-004781.
To explore the views of optometrists, general practitioners (GPs) and ophthalmologists regarding the development and organisation of community-based enhanced optometric services.
Qualitative study using free-text questionnaires and telephone interviews.
A minor eye conditions scheme (MECS) and a glaucoma referral refinement scheme (GRRS) are based on accredited community optometry practices.
41 optometrists, 6 ophthalmologists and 25 GPs.
The most common reason given by optometrists for participation in enhanced schemes was to further their professional development; however, as providers of 'for-profit' healthcare, it was clear that participants had also considered the impact of the schemes on their business. Lack of fit with the 'retail' business model of optometry was a frequently given reason for non-participation. The methods used for training and accreditation were generally thought to be appropriate, and participating optometrists welcomed the opportunities for ongoing training. The ophthalmologists involved in the MECS and GRRS expressed very positive views regarding the schemes and widely acknowledged that the new care pathways would reduce unnecessary referrals and shorten patient waiting times. GPs involved in the MECS were also very supportive. They felt that the scheme provided an 'expert' local opinion that could potentially reduce the number of secondary care referrals.
The results of this study demonstrated strong stakeholder support for the development of community-based enhanced optometric services. Although optometrists welcomed the opportunity to develop their professional skills and knowledge, enhanced schemes must also provide a sufficient financial incentive so as not to compromise the profitability of their business.
探讨验光师、全科医生（GPs）和眼科医生对基于社区的强化验光服务的发展和组织的看法。
采用自由文本问卷和电话访谈的定性研究。
一个轻微眼部疾病计划（MECS）和一个青光眼转诊优化计划（GRRS）基于经认可的社区验光实践。
41名验光师、6名眼科医生和25名全科医生。
验光师参与强化计划最常见的原因是促进自身职业发展；然而，作为“营利性”医疗服务的提供者，很明显参与者也考虑了这些计划对其业务的影响。与验光“零售”商业模式不匹配是经常被提及的不参与原因。培训和认证所采用的方法普遍被认为是合适的，参与计划的验光师欢迎持续培训的机会。参与MECS和GRRS的眼科医生对这些计划表达了非常积极的看法，并广泛认可新的护理途径将减少不必要的转诊并缩短患者等待时间。参与MECS的全科医生也非常支持。他们认为该计划提供了当地的“专家”意见，有可能减少二级护理转诊的数量。
本研究结果表明利益相关者对基于社区的强化验光服务的发展给予了大力支持。虽然验光师欢迎有机会发展他们的专业技能和知识，但强化计划也必须提供足够的经济激励，以免影响其业务的盈利能力。
