Dilts D M, Khamalah J, Plotkin A
Department of Management Sciences, University of Waterloo, Ontario, Canada.
Optom Vis Sci. 1994 Jul;71(7):422-36. doi: 10.1097/00006324-199407000-00002.
In an era of increased demands and constrained budgets, it is necessary to make the best use of all available resources. This is difficult when specialized vision care, such as low vision clinical assessment, is involved because of the heterogeneity of the patient populations seen by such clinics. PURPOSE. This research attempts to discover if these diverse patient populations can be identified and clustered into groups based upon similarity of clinical resources use. Specifically, the inquiry examines the potential for a low vision patient resource utilization classification scheme at the Low Vision Clinic (LVC) in the Centre for Sight Enhancement (CSE), University of Waterloo. METHODS. From a sample of 99 patients consulting the LVC in a 3-month period, retrospective data collection involved abstracting and coding medical records containing information detailing each patient's demographic, diagnostic, therapeutic, and resource utilization characteristics. Cluster analysis using Hartigan's block clustering algorithm was then applied to the data. A replication study was completed using a sample of 99 patients visiting the LVC 1 year later. RESULTS. Patients can be classified into five iso-resource groups, hereby termed low vision patient resource groups (LVPRGs). The clusters represent a resource consistent and clinically coherent scheme for classifying low vision patients based upon resource requirements. As a measure of repeatability, the groups reemerged in the replication study. CONCLUSIONS. If the groupings demonstrate robustness in a field test, clustering algorithms in general, and LVPRGs in specific, may offer useful tools to enhance resource utilization in the LVC setting.
在一个需求不断增加而预算受限的时代,充分利用所有可用资源很有必要。然而,当涉及到诸如低视力临床评估等专业视力保健时,由于此类诊所接待的患者群体具有异质性,这一目标很难实现。目的。本研究旨在探究是否可以根据临床资源使用的相似性,识别这些不同的患者群体并将其聚类分组。具体而言,该调查研究了滑铁卢大学视力增强中心(CSE)的低视力诊所(LVC)制定低视力患者资源利用分类方案的可能性。方法。从三个月内咨询LVC的99名患者样本中,通过回顾性数据收集,提取并编码病历,其中包含详细记录每位患者的人口统计学、诊断、治疗和资源利用特征的信息。然后将使用哈蒂根块聚类算法的聚类分析应用于这些数据。一年后,使用99名访问LVC的患者样本完成了一项重复研究。结果。患者可分为五个等资源组,在此称为低视力患者资源组(LVPRG)。这些聚类代表了一种基于资源需求对低视力患者进行分类的资源一致且临床连贯的方案。作为可重复性的衡量标准,这些组在重复研究中再次出现。结论。如果这些分组在现场测试中表现出稳健性,那么一般的聚类算法,特别是LVPRG,可能会提供有用的工具来提高LVC环境中的资源利用效率。