视力检查费用：对眼科转诊及青光眼检出率的影响
The sight test fee: effect on ophthalmology referrals and rate of glaucoma detection.
作者信息
Laidlaw D A, Bloom P A, Hughes A O, Sparrow J M, Marmion V J
机构信息
Bristol Eye Hospital.
出版信息
BMJ. 1994 Sep 10;309(6955):634-6. doi: 10.1136/bmj.309.6955.634.
OBJECTIVE
To assess changes, if any, in the numbers of referrals and outcome of glaucoma referrals to the hospital eye service since the introduction of the sight test fee on 1 April 1989.
DESIGN
Review of referral records and clinical notes.
SETTING
Referrals to the Bristol Eye Hospital.
SUBJECTS
51,919 patients referred to the Bristol Eye Hospital between 1984 and 1992. 9438 case notes of patients referred between 1987 and 1991 were examined in detail.
MAIN OUTCOME MEASURES
Numbers of referrals; rate of adult true positive glaucoma referrals.
RESULTS
Referrals to the Bristol Eye Hospital were between 13.7% and 19.0% fewer than expected after the introduction of the sight test fee. True positive glaucoma referrals were reduced by the same proportion.
CONCLUSIONS
The numbers of patients being identified as requiring treatment or follow up for potentially blinding glaucoma have declined by nearly one fifth since the introduction of the sight test fee. An increased prevalence of preventable blindness may result.
目的
评估自1989年4月1日引入视力检查费用以来，转诊至医院眼科服务的青光眼转诊数量及结果的变化（如有）。
设计
回顾转诊记录和临床笔记。
地点
转诊至布里斯托尔眼科医院。
研究对象
1984年至1992年间转诊至布里斯托尔眼科医院的51919名患者。详细检查了1987年至1991年间转诊患者的9438份病例记录。
主要观察指标
转诊数量；成人青光眼真阳性转诊率。
结果
引入视力检查费用后，转诊至布里斯托尔眼科医院的患者比预期少13.7%至19.0%。青光眼真阳性转诊减少了相同比例。
结论
自引入视力检查费用以来，被确定需要治疗或随访潜在致盲性青光眼的患者数量下降了近五分之一。可能会导致可预防失明的患病率增加。
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