Nash E A, Margo C E
Department of Ophthalmology, University of South Florida, College of Medicine, Tampa, USA.
Arch Ophthalmol. 1998 Sep;116(9):1222-6. doi: 10.1001/archopht.116.9.1222.
To characterize the magnitude and patterns of visits to the emergency department (ED) for problems related to the eye and ocular adnexa.
The National Hospital Ambulatory Medical Care Survey was used to obtain information on ED visits in the United States for conditions of the eye and ocular adnexa in 1993. Patients were identified by International Classification of Diseases, Ninth Revision, Clinical Modification, codes. National projections were based on a staged probability design.
There were 2.32 million projected ED visits for problems of the eye and ocular adnexa in 1993. Forty-nine percent of visits were for injuries, two thirds of which occurred in males. Thirty-five percent of injuries occurred in the home and 18% occurred in the workplace. Only 3% of patients required hospitalization. Most patients had private insurance, but substantial variations in coverage existed for patients who used the ED for injury- vs non-injury-related care.
Emergency departments in the United States provide a large amount of eye care, much of which is for conditions other than trauma. Differences in insurance coverage for injury- and non-injury-related eye care indicate that factors other than medical urgency are involved in the decision to use ED services. Further studies are needed to determine the cost-effectiveness and quality of ocular-related ED visits.
描述因眼部及眼附属器相关问题前往急诊科就诊的数量及模式。
利用国家医院门诊医疗调查获取1993年美国因眼部及眼附属器疾病前往急诊科就诊的信息。通过国际疾病分类第九版临床修订本编码识别患者。国家预测基于分层概率设计。
1993年预计因眼部及眼附属器问题前往急诊科就诊的人数为232万。49%的就诊是因受伤，其中三分之二发生在男性身上。35%的受伤发生在家中，18%发生在工作场所。只有3%的患者需要住院治疗。大多数患者有私人保险，但因受伤和非受伤相关护理而使用急诊科的患者在保险覆盖方面存在很大差异。
美国的急诊科提供大量的眼部护理，其中大部分是针对外伤以外的情况。受伤和非受伤相关眼部护理的保险覆盖差异表明，使用急诊科服务的决定涉及医疗紧迫性以外的因素。需要进一步研究来确定与眼部相关的急诊科就诊的成本效益和质量。
