Lynch Mary G, Maa April, Delaune William, Chasan Joel, Cockerham Glenn C
Ophthalmology Section, VA Medical Center, 1670 Clairmont Road, Decatur, GA 30033.
Center for Visual and Neurocognitive Rehabilitation, 1670 Clairmont Road, Decatur, GA 30033.
Mil Med. 2017 Jan;182(1):e1631-e1635. doi: 10.7205/MILMED-D-16-00103.
Eye care in the Veterans Affairs Health Care System is challenged with increasing demand and higher prevalence of patients with complex ocular conditions. Understanding factors that impact eye care productivity and access is necessary for appropriate allocation of resources. The purpose of this study was to determine the impact of various eye clinic personnel on eye care provider productivity and patient access.
Utilizing data from the Veterans Health Administration National Data Warehouse, workload and level of staffing were analyzed. Trends in the data were analyzed using descriptive and regression analyses employing both linear and curve fitting modeling methods.
There was a significant positive correlation between ophthalmology technicians and ophthalmologist productivity (p < 0.001), number of unique patients seen per year per provider (p = 0.047), and total yearly number of office visits per provider (p < 0.001). Similarly, there was a significant positive correlation between number of ophthalmology residents and productivity (p = 0.046) and number of clinic visits per provider (p < 0.001) but not the number of unique patients seen. Positive correlation was found between optometry technicians and the number of unique patients' seen by optometrists (p = 0.041) and total number of clinic visits per provider (p < 0.001) but not optometrist productivity. No significant correlations were present for nurses, nurse practitioners, physician assistants, or clerical staff.
Eye care technicians provide a cost-effective multiplier effect for provider productivity, especially in ophthalmology clinics, allowing significant increases in total clinic visits and number of unique patients seen per year.
退伍军人事务医疗保健系统中的眼科护理面临着需求不断增加以及患有复杂眼部疾病患者的患病率不断上升的挑战。了解影响眼科护理生产力和可及性的因素对于合理分配资源至关重要。本研究的目的是确定各类眼科诊所人员对眼科护理提供者生产力和患者可及性的影响。
利用退伍军人健康管理局国家数据仓库的数据，分析工作量和人员配备水平。使用描述性分析和回归分析，采用线性和曲线拟合建模方法对数据趋势进行分析。
眼科技术员与眼科医生生产力之间存在显著正相关（p < 0.001），每位提供者每年诊治的独特患者数量（p = 0.047）以及每位提供者每年的门诊总数（p < 0.001）。同样，眼科住院医师数量与生产力（p = 0.046）以及每位提供者的门诊次数（p < 0.001）之间存在显著正相关，但与诊治的独特患者数量无关。验光技术员与验光师诊治的独特患者数量（p = 0.041）以及每位提供者的门诊总数（p < 0.001）之间存在正相关，但与验光师生产力无关。护士、执业护士、医师助理或文职人员之间未发现显著相关性。
眼科护理技术员为提供者生产力提供了具有成本效益的倍增效应，尤其是在眼科诊所，可使每年的门诊总数和诊治的独特患者数量显著增加。
