iCareTrack: measuring the appropriateness of eyecare delivery in Australia.
appropriateness of care
diabetic retinopathy
glaucoma
preventative eyecare
record audit
record review
Journal
Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)
ISSN: 1475-1313
Titre abrégé: Ophthalmic Physiol Opt
Pays: England
ID NLM: 8208839
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
12
03
2020
accepted:
07
05
2020
pubmed:
5
6
2020
medline:
22
7
2021
entrez:
5
6
2020
Statut:
ppublish
Résumé
To meet the needs of an ageing population and optimise health expenditure, delivery of care should be based on evidence. However, the level of evidence-based care delivered to patients with eye conditions is rarely assessed. This study thus aimed to determine the percentage of eyecare encounters at which a sample of adult Australians received appropriate care (i.e., eyecare in line with evidence-based or consensus-based guidelines). A cross-sectional retrospective review of optometry practice records was conducted using random stratified (by state) sampling in mainland Australia. Eighty-five clinical indicators were developed from evidence-based clinical practice guideline recommendations and refined by panels of experts using a modified Delphi process. Healthcare records of patients 18 years and over were examined against these indicators, representing appropriate care for three common eye conditions (preventative eyecare, glaucoma, and diabetic eyecare). Encounters occurred in optometry practices that were selected to be representative of the socioeconomic profile of Australian practices. The primary outcome measure was percentage compliance of eyecare delivery against the clinical indicators. From 426 optometry practices contacted by mail or telephone, 90 (21%) replied, 46 proved eligible and 42 were included in the study and visited for data collection. From these 1260 patient records were reviewed. Appropriate eyecare was received by Australian patients at an average of 71% (95%CI 70%, 73%) of eligible encounters. The percentage of appropriateness of eyecare at the condition level for preventative, glaucoma and diabetic eyecare was 81% (95%CI 79%, 83%), 63% (95%CI 61%, 64%), and 69% (95%CI 66%, 73%), respectively. Appropriateness of eyecare delivery was lowest for the domains of history taking and physical examination for all eye conditions. There were pockets of excellence but consistent delivery of appropriate eyecare needs improvement, and gaps in eyecare delivery should be addressed.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
433-441Informations de copyright
© 2020 The Authors Ophthalmic & Physiological Optics © 2020 The College of Optometrists.
Références
Access Economics. Clear focus-The economic impact of vision loss in Australia in 2009: A report prepared by ccess Economics Pty Limited. Vision 2020 Australia: Melbourne, 2010.
Foreman J, Keel S, Xie Jet al. The National Eye Health Survey 2016: Centre for Eye Research Australia, Vision 2020 Australia, 2016; http://www.vision2020australia.org.au/uploads/resource/250/National-Eye-Health-Survey_Full-Report_FINAL.pdf
Claiborne Johnston S & Hauser SL. T2 clinical research: judgment day. Ann Neurol 2008; 63: A15-A16.
McGlynn EA, Asch SM, Adams J et al. The quality of health care delivered to adults in the United States. N Engl J Med 2003; 348: 2635-2645.
Runciman WB, Hunt TD, Hannaford NA et al. CareTrack: assessing the appropriateness of health care delivery in Australia. Med J Aust 2012; 197: 100-105.
Ho KC, Stapleton F, Wiles L et al. Systematic review of the appropriateness of eye care delivery in eye care practice. BMC Health Serv Res 2019; 19: 646.
Ho KC, Rahardjo D, Stapleton F et al. Measuring the appropriateness of eye care in Australia: protocol for a retrospective record review. Optom Vis Sci 2019; 96: E-abstract 195237.
Ho KC, Rahardjo D, Stapleton F et al. Can the appropriateness of eye care be measured through cross-sectional retrospective patient record review in eye care practices in Australia? The iCareTrack feasibility study. BMJ Open 2019; 9: e024298.
Hunt TD, Ramanathan SA, Hannaford NA et al. CareTrack Australia: assessing the appropriateness of adult healthcare: protocol for a retrospective medical record review. BMJ Open 2012; 2: e000665.
Kim JY, Farmer P & Porter ME. Redefining global health-care delivery. Lancet 2013; 382: 1060-1069.
Taylor HR, Keeffe JE, Vu HT et al. Vision loss in Australia. Med J Aust 2005; 182: 565-568.
Dirani M, Crowston JG, Taylor PS et al. Economic impact of primary open-angle glaucoma in Australia. Clin Experiment Ophthalmol 2011; 39: 623-632.
National Health and Medical Research Council. Guidelines for the Management of Diabetic Retinopathy, National Health & Medical Research Council: Canberra, 2008. http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/di15.pdf.
National Health and Medical Research Council. NHMRC guidelines for the screening, prognosis, diagnosis, management and prevention of glaucoma. 2010 (29 July 2015). https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/cp113_glaucoma_120404.pdf.
Hajian-Tilaki K. Sample size estimation in epidemiologic studies. Caspian J Intern Med 2011; 2: 289-298.
Australian Bureau of Statistics. Australian Demographic Statistics, Dec 2014, cat. no. 3101.02015 18th Jul 2017. http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/3101.0Main+Features1Dec%202014?OpenDocument.
ACIL Allen Consulting. Market analysis of optometry practice in Australia 2014. http://www.acilallen.com.au/cms_files/0ACILAllen_optometry2014.pdf
Australian Government Department of Health. Medicare Benefits Schedule Book. Optometrical Services Schedule. Australian Government Department of Health: Canberra, 2013.
Damji KF, Behki R & Wang L& Target IOPWp. Canadian perspectives in glaucoma management: setting target intraocular pressure range. Can J Ophthalmol 2003; 38: 189-197.
Canadian Ophthalmological Society Glaucoma Clinical Practice Guideline Expert C, Canadian Ophthalmological S. Canadian Ophthalmological Society evidence-based clinical practice guidelines for the management of glaucoma in the adult eye. Can J Ophthalmol 2009; 44(Suppl 1): S7-S93.
Chan P, Thyparampil PJ & Chiang MF. Accuracy and speed of electronic health record versus paper-based ophthalmic documentation strategies. Am J Ophthalmol 2013; 156: 165-172.e2.
Shah R, Edgar DF & Evans BJ. How well does record abstraction quantify the content of optometric eye examinations in the UK? Ophthalmic Physiol Opt 2009; 29: 383-396.