Clendenin C, Coffey M, Marsh M, West S
Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland 21287-9019, USA.
Br J Ophthalmol. 1997 Nov;81(11):972-5. doi: 10.1136/bjo.81.11.972.
AIMS/BACKGROUND: This investigation determined eye care utilisation patterns in a rural county in Ireland. Population based estimates of visual impairment and glaucoma were available, so the two studies will optimise planning for eye care services for the county.
Roscommon has a population of 55,000 served by one ophthalmologist and two optometrists. Data were collected on all outpatient visits for all providers for a 3 month period. Information was abstracted on demographics, presenting and final diagnoses. Expected number of visits for glaucoma were calculated using the population structure and rates of glaucoma, and assuming one visit per year per glaucoma patient.
1398 patients had a total of 1442 visits in 3 months. A third of the visits were to optometrists, and all but 21 visits were for normal eye examinations or glasses. The majority of children aged less than 16 years, and people older than 60 years were seen by the ophthalmologist. Among children, 81% of all visits were to the ophthalmologist and 92% were classified as a normal examination. Only an estimated 188 visits per year for glaucoma were observed, compared with 1100 expected.
In this rural county, many of the visits to the ophthalmologist were for normal eye examination, particularly among children. Screening algorithms which would free the ophthalmologist to see more complicated problems could be considered. There is an underutilisation of services by glaucoma patients. Reasons for this are described.
目的/背景：本调查确定了爱尔兰一个乡村县的眼保健利用模式。基于人口的视力损害和青光眼估计数据是可用的，因此这两项研究将优化该县眼保健服务的规划。
罗斯康芒郡有55000人口，由一名眼科医生和两名验光师提供服务。收集了所有医疗服务提供者在3个月期间的所有门诊就诊数据。提取了有关人口统计学、初诊和最终诊断的信息。使用人口结构和青光眼发病率，并假设每位青光眼患者每年就诊一次，计算青光眼的预期就诊次数。
1398名患者在3个月内共就诊1442次。三分之一的就诊是去验光师处，除21次外，所有就诊都是进行正常眼部检查或配镜。大多数16岁以下儿童和60岁以上人群由眼科医生诊治。在儿童中，所有就诊的81%是去看眼科医生，92%被归类为正常检查。每年观察到的青光眼就诊次数估计仅为188次，而预期为1100次。
在这个乡村县，许多去看眼科医生的就诊是进行正常眼部检查，尤其是在儿童中。可以考虑采用筛查算法，使眼科医生能够腾出时间处理更复杂的问题。青光眼患者对服务的利用不足。文中描述了其原因。
