Damento Gena M, Winkler Nelson S, Hodge David O, Khanna Sunil S, Khanna Cheryl L
a Department of Ophthalmology , Mayo Clinic , Rochester , MN , USA.
b Mayo Clinic , Jacksonville , FL , USA.
Semin Ophthalmol. 2018;33(7-8):829-837. doi: 10.1080/08820538.2018.1514059. Epub 2018 Sep 21.
To determine the effect of a glaucoma team care model on resource utilization and efficiency in glaucoma management.
Retrospective cohort study of 358 patients diagnosed and treated for glaucoma. Analysis included number of patient visits, diagnostic tests, and glaucoma procedures performed before (2005-2007) and after (2008-2010) implementation of a team care model in 2008. Patients not involved in the model served as controls.
Number of patient visits did not change significantly after model implementation (p > .05). Diagnostic tests significantly increased in comprehensive ophthalmologist and glaucoma subspecialist groups 25 months after diagnosis (p = .03 and p = .001). Procedures increased for glaucoma subspecialists but was not statistically significant (p = .06). Optometrists used billing codes with significantly lower reimbursement than other providers (p < .001).
Team care model had neutral effect on patient visits and increased testing. Continued evaluation of this model is required to determine its effect on disease progression and outcomes.
确定青光眼团队护理模式对青光眼管理中资源利用和效率的影响。
对358例诊断并接受青光眼治疗的患者进行回顾性队列研究。分析内容包括2008年实施团队护理模式之前（2005 - 2007年）和之后（2008 - 2010年）患者的就诊次数、诊断测试以及青光眼手术的情况。未参与该模式的患者作为对照。
模式实施后患者就诊次数无显著变化（p >.05）。诊断后25个月，综合眼科医生和青光眼专科医生组的诊断测试显著增加（p =.03和p =.001）。青光眼专科医生实施的手术增加，但无统计学意义（p =.06）。验光师使用的计费代码报销费用明显低于其他提供者（p <.001）。
团队护理模式对患者就诊次数有中性影响，并增加了检查。需要对该模式进行持续评估，以确定其对疾病进展和结局的影响。
