Burnett Anthea M, Morse Anna, Naduvilath Thomas, Boudville Andrea, Taylor Hugh R, Bailie Ross
Brien Holden Vision Institute, Public Health, Sydney, NSW, Australia; Vision CRC, Sydney, NSW, Australia; School of Optometry and Vision Science, University of New South Wales, Kensington, NSW, Australia.
Brien Holden Vision Institute, Public Health, Sydney, NSW, Australia; Vision CRC, Sydney, NSW, Australia.
Front Public Health. 2016 Dec 19;4:276. doi: 10.3389/fpubh.2016.00276. eCollection 2016.
Routine eye and vision assessments are vital for the detection and subsequent management of vision loss, which is particularly important for Aboriginal and Torres Strait Islander people who face higher rates of vision loss than other Australians. In order to guide improvements, this paper will describe patterns, variations, and gaps in these eye and vision assessments for Aboriginal and Torres Strait Islander people.
Clinical audits from 124 primary healthcare centers (sample size 15,175) from five Australian states and territories were conducted during 2005-2012. Main outcome measure was adherence to current guidelines for delivery of eye and vision assessments to adults with diabetes, those without a diagnosed major chronic disease and children attending primary healthcare centers.
Overall delivery of recommended eye and vision assessments varied widely between health centers. Of the adults with diabetes, 46% had a visual acuity assessment recorded within the previous 12 months (health center range 0-88%) and 33% had a retinal examination recorded (health center range 0-73%). Of the adults with no diagnosed major chronic disease, 31% had a visual acuity assessment recorded within the previous 2 years (health center range 0-86%) and 13% had received an examination for trichiasis (health center range 0-40%). In children, 49% had a record of a vision assessment (health center range 0-97%) and 25% had a record of an examination for trachoma within the previous 12 months (health center range 0-100%).
There was considerable range and variation in the recorded delivery of scheduled eye and vision assessments across health centers. Sharing the successful strategies of the better-performing health centers to support focused improvements in key areas of need may increase overall rates of eye examinations, which is important for the timely detection, referral, and treatment of eye conditions affecting Aboriginal and Torres Strait Islander people, especially for those with diabetes.
常规眼部和视力评估对于视力丧失的检测及后续管理至关重要，这对于面临比其他澳大利亚人更高视力丧失率的原住民和托雷斯海峡岛民尤为重要。为了指导改进工作，本文将描述原住民和托雷斯海峡岛民眼部和视力评估的模式、差异及差距。
2005年至2012年期间，对来自澳大利亚五个州和领地的124个初级医疗保健中心（样本量为15175）进行了临床审计。主要结果指标是对向患有糖尿病的成年人、未被诊断患有重大慢性病的成年人以及在初级医疗保健中心就诊的儿童进行眼部和视力评估的现行指南的遵循情况。
各医疗中心之间推荐的眼部和视力评估的总体实施情况差异很大。在患有糖尿病的成年人中，46%在过去12个月内有视力评估记录（医疗中心范围为0 - 88%），33%有视网膜检查记录（医疗中心范围为0 - 73%）。在未被诊断患有重大慢性病的成年人中，31%在过去2年内有视力评估记录（医疗中心范围为0 - 86%），13%接受了倒睫检查（医疗中心范围为0 - 40%）。在儿童中，49%有视力评估记录（医疗中心范围为0 - 97%），25%在过去12个月内有沙眼检查记录（医疗中心范围为0 - 100%）。
各医疗中心在按计划进行的眼部和视力评估记录方面存在相当大的范围和差异。分享表现较好的医疗中心的成功策略，以支持在关键需求领域进行有针对性的改进，可能会提高眼部检查的总体比例，这对于及时发现、转诊和治疗影响原住民和托雷斯海峡岛民的眼部疾病非常重要，特别是对于糖尿病患者。
