De Silva Ian, Thomas Mervyn G, Shirodkar Amy-Lee, Kuht Helen J, Ku Jae Yee, Chaturvedi Ritu, Beer Freddy, Patel Radhika, Rana-Rahman Romeela, Anderson Sarah, Dickerson Polly, Walsh Francine, While Ben, Clarke Lucy, Siriwardena Dilani, Dhawahir-Scala Felipe, Buchan John, Verma Seema
Department of Ophthalmology, University Hospitals of Leicester, Leicester Royal Infirmary, Leicester, LE1 5WW, UK.
The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester, PO Box 65, Leicester, LE2 7LX, UK.
Eye (Lond). 2022 Dec;36(12):2304-2311. doi: 10.1038/s41433-021-01849-8. Epub 2021 Nov 30.
BACKGROUND/OBJECTIVES: To characterise the patterns of presentation and diagnostic frequencies in Hospital Emergency Eye Care Services (HEECS) across 13 hospitals in England.
Retrospective, cross-sectional, observational multi-centre (n = 13) study to assess HEECS attendances over a 28-day study period. Data derived included: number of consecutive attendances, patient demographics and diagnoses. Age and gender variations, the impact of day of the week on attendance patterns, diagnostic frequencies and estimates of the annual incidence and attendance rates were evaluated.
A total of 17,667 patient (mean ± standard deviation age = 49.6 ± 21.8 years) attendances were identified with an estimated HEECS annual new attendance rate of 31.0 per 1,000 population. Significantly more females (53%) than males (47%) attended HEECS (p < 0.001). Female attendances were 13% higher in those ≥50 years of age. Weekends were associated with a significant reduction in attendances compared to weekdays (χ = 6.94, p < 0.001). Among weekdays, Mondays and Fridays were associated with significantly higher attendances compared with midweek (χ = 2.20, p = 0.032). Presenting pathologies involving the external eye, cornea and conjunctiva accounted for 28.6% of the caseload.
This is the largest multicentre study assessing attendance patterns in HEECS in England. We have, for the first time, observed a "weekend effect" in relation to attendance to HEECS. Differences in health-seeking behaviour and lack of awareness of HEECS weekend services may be partly attributed to the differences observed. Our findings, along with the type of presentations, have the potential to guide commissioners with future planning of HEECS.
背景/目的：描述英格兰13家医院的急诊眼科护理服务（HEECS）中的就诊模式和诊断频率。
进行回顾性、横断面、多中心（n = 13）观察性研究，以评估28天研究期间的HEECS就诊情况。收集的数据包括：连续就诊次数、患者人口统计学信息和诊断结果。评估了年龄和性别差异、一周中不同日期对就诊模式的影响、诊断频率以及年发病率和就诊率的估计值。
共确定了17667例患者就诊（平均年龄±标准差=49.6±21.8岁），估计HEECS的年新就诊率为每1000人中有31.0例。就诊于HEECS的女性（53%）明显多于男性（47%）（p < 0.001）。50岁及以上女性的就诊率高出13%。与工作日相比，周末就诊人数显著减少（χ = 6.94，p < 0.001）。在工作日中，周一和周五的就诊人数明显高于周中（χ = 2.20，p = 0.032）。涉及眼外部、角膜和结膜的就诊病例占病例总数的28.6%。
这是评估英格兰HEECS就诊模式的最大规模多中心研究。我们首次观察到与HEECS就诊相关的“周末效应”。寻求医疗行为的差异以及对HEECS周末服务缺乏了解可能部分归因于观察到的差异。我们的研究结果以及就诊类型，有可能为HEECS的未来规划指导专员提供参考。
