Lim Ernest, Kanda Mumta, Rodrigues Zena, Hussain Rohan, Lee Vickie
Western Eye Hospital, Imperial College Healthcare NHS Trust, London, UK.
Int J Care Coord. 2022 Jun;25(2-3):66-74. doi: 10.1177/20534345221092512.
To explore patient and clinician perspectives on acute ophthalmology presentations during the COVID pandemic. To ascertain whether the pandemic had differentially impacted access to care based on patient demographics and postcodes.
A single-centre, cross-sectional prospective study in a busy metropolitan eye casualty between April-June 2020 recording patient demographics, distance travelled to access healthcare, diagnosis and outcome compared to the equivalent period in 2019. A further two-part survey was conducted to explore patient and clinician's perceptions around delays in attendances, views on remote consultation and severity of the condition.
There was a 68% decrease in April 2020 compared to previous year's ED attendance. The diagnosis tended towards more visually significant pathology. From 2019 to 2020, there was a significant decrease in average distance travelled to the eye emergency department (eye ED). working-age adults (18-59) and white patients travelling from very far pre-pandemic contributed most to this change. 513 Patient responses (12%) out of 4433 attendances during the study period were received, 89% (456/513) of the completed surveys also had matching clinician surveys. 29% (149/513) patients felt COVID-19 stopped them from attending earlier. Clinicians thought a video consultation would have been suitable for 40% (182/456) of patients compared to only 13% (58/456) of patients preferring a video consultation.
Although our findings were limited by low response rates, COVID-19 may have caused a delay in presentation for emergency eye care. Demographic changes and attitudes towards video consultations have implications for planning of emergency eye care in future pandemics.
探讨在新冠疫情期间患者和临床医生对急性眼科疾病就诊情况的看法。确定疫情是否根据患者人口统计学特征和邮政编码对获得医疗服务产生了不同影响。
于2020年4月至6月在一个繁忙的大都市眼科急诊中心进行了一项单中心横断面前瞻性研究,记录患者人口统计学特征、就医行程距离、诊断结果以及与2019年同期相比的治疗结果。还进行了另外一项两部分的调查,以探讨患者和临床医生对就诊延迟的看法、对远程会诊的意见以及病情的严重程度。
与上一年急诊科就诊人数相比,2020年4月下降了68%。诊断结果倾向于更具视觉显著性的病理情况。从2019年到2020年,前往眼科急诊科的平均行程距离显著减少。疫情前从很远地方前来就诊的工作年龄成年人(18 - 59岁)和白人患者对这一变化的贡献最大。在研究期间的4433次就诊中,收到了513份患者回复(12%),在完成的调查中,89%(456/513)也有相应的临床医生调查结果。29%(149/513)的患者认为新冠疫情使他们未能更早就诊。临床医生认为视频会诊适合40%(182/456)的患者,而只有13%(58/456)的患者倾向于视频会诊。
尽管我们的研究结果受到低回复率的限制,但新冠疫情可能导致了紧急眼科护理就诊的延迟。人口统计学变化和对视频会诊的态度对未来疫情期间紧急眼科护理的规划具有影响。