Literature DB >> 33867880

Utilization trends of an ophthalmology-specific emergency department: the Massachusetts Eye and Ear experience.

Leangelo N Hall1, Karen W Jeng-Miller1, Matthew Gardiner1, Esther Lee Kim1.   

Abstract

PURPOSE: To describe the utilization trends of a dedicated ophthalmology emergency department (ED) in Boston, Massachusetts.
METHODS: The medical records of 500 randomly selected patients who presented at the Massachusetts Eye and Ear (MEE) Emergency Department (ED) from January 2015 to March 2016 were reviewed retrospectively. Data were analyzed using the Pearson χ2 test and multiple logistic regression. The primary study outcome measure was whether a patient's visit was emergent or nonemergent. Emergent or nonemergent conditions were classified based on the diagnosis and treatment required at follow-up appointments. Nonemergent diagnoses were classified as conditions that could have been seen as an outpatient without negative consequences for vision.
RESULTS: Of the 500 cases, 252 were males and 248 were females. The median age was 45 years (range, 2-101 years). The most common diagnoses were posterior vitreous detachment (8.6%), corneal abrasion (8.4%), dry eye syndrome (7%), and viral conjunctivitis (5.4%). Of the total, 92.6% of patients originated from within Massachusetts. The majority of patients were self-referred (78.6%) or referred from another hospital (12.8%). Nonemergent visits accounted for 49.4% of patients seen. Compared to patients who presented with duration of symptoms for ≥1 week, patients who presented with symptoms of <1 week were more likely to present with an emergent condition (8.8% vs 41.8%). Referrals from an outside ophthalmologist or hospital were predictive of emergent patient visits (OR, resp., 1.971 [95% CI, 0.478-3.462; P = 0.01]; 1.040 [95% CI, 0.462-1.616; P < 0.001]).
CONCLUSIONS: In our study, nonemergent patient visits comprised nearly half of all ophthalmology ED visits. Emergent visits were associated with acute symptoms and referrals from outside healthcare providers.
Copyright ©2020. All rights reserved. Reproduction in whole or in part in any form or medium without expressed written permission of the Digital Journal of Ophthalmology is prohibited.

Entities:  

Mesh:

Year:  2020        PMID: 33867880      PMCID: PMC8031954          DOI: 10.5693/djo.01.2020.02.002

Source DB:  PubMed          Journal:  Digit J Ophthalmol        ISSN: 1542-8958


  14 in total

1.  Assessment of referrals to the hospital eye service by optometrists and GPs in Bradford and Airedale.

Authors:  Christopher J Davey; Clare Green; David B Elliott
Journal:  Ophthalmic Physiol Opt       Date:  2010-11-11       Impact factor: 3.117

2.  Analysis of ophthalmology workforce and delivery of emergency department eye care in Florida.

Authors:  Matthew T Witmer; Curtis E Margo
Journal:  Arch Ophthalmol       Date:  2009-11

3.  A general practitioner in an ophthalmology accident and emergency department.

Authors:  M Price; C I Phillips
Journal:  Br Med J       Date:  1976-08-28

4.  An audit of the ophthalmic division of the accident and emergency department of the Royal Victoria Eye and Ear Hospital, Dublin.

Authors:  S Fenton; E Jackson; M Fenton
Journal:  Ir Med J       Date:  2001-10

5.  Function of an ophthalmic "accident and emergency" department: results of a six month survey.

Authors:  N P Jones; J M Hayward; P T Khaw; C M Claoué; A R Elkington
Journal:  Br Med J (Clin Res Ed)       Date:  1986-01-18

6.  Cost and Visit Duration of Same-Day Access at an Academic Ophthalmology Department vs Emergency Department.

Authors:  Eric L Singman; Kerry Smith; Radhika Mehta; Michael V Boland; Divya Srikumaran; Kevin Frick; Lynne Young; Gina Locco; Jing Tian; Cathy Kowalewski; Peter McDonnell
Journal:  JAMA Ophthalmol       Date:  2019-07-01       Impact factor: 7.389

7.  Nonurgent emergency department patient characteristics and barriers to primary care.

Authors:  Jonathan Afilalo; Adrian Marinovich; Marc Afilalo; Antoinette Colacone; Ruth Léger; Bernard Unger; Claudine Giguère
Journal:  Acad Emerg Med       Date:  2004-12       Impact factor: 3.451

8.  Epidemiology of Eye-Related Emergency Department Visits.

Authors:  Roomasa Channa; Syed Nabeel Zafar; Joseph K Canner; R Sterling Haring; Eric B Schneider; David S Friedman
Journal:  JAMA Ophthalmol       Date:  2016-03       Impact factor: 7.389

9.  Ophthalmology emergency room at the University of São Paulo General Hospital: a tertiary hospital providing primary and secondary level care.

Authors:  Regina de Souza Carvalho; Newton Kara José
Journal:  Clinics (Sao Paulo)       Date:  2007-06       Impact factor: 2.365

Review 10.  Emergency department visits for nonurgent conditions: systematic literature review.

Authors:  Lori Uscher-Pines; Jesse Pines; Arthur Kellermann; Emily Gillen; Ateev Mehrotra
Journal:  Am J Manag Care       Date:  2013-01       Impact factor: 2.229

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