TY - JOUR
T1 - iCareTrack
T2 - measuring the appropriateness of eyecare delivery in Australia
AU - Ho, Kam Chun
AU - Stapleton, Fiona
AU - Wiles, Louise
AU - Hibbert, Peter
AU - White, Andrew
AU - Jalbert, Isabelle
N1 - Funding Information:
This work was supported by a UNSW Sydney Tuition Fee Scholarship [to KCH]; a UNSW Sydney Faculty of Science June Griffith Fellowship [to IJ]; and a UNSW Sydney Faculty of Science Research Program Grant.
Publisher Copyright:
© 2020 The Authors Ophthalmic & Physiological Optics © 2020 The College of Optometrists
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Purpose: 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). Methods: 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. Results: 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. Conclusions: There were pockets of excellence but consistent delivery of appropriate eyecare needs improvement, and gaps in eyecare delivery should be addressed.
AB - Purpose: 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). Methods: 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. Results: 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. Conclusions: There were pockets of excellence but consistent delivery of appropriate eyecare needs improvement, and gaps in eyecare delivery should be addressed.
KW - appropriateness of care
KW - diabetic retinopathy
KW - glaucoma
KW - preventative eyecare
KW - record audit
KW - record review
UR - http://www.scopus.com/inward/record.url?scp=85085901222&partnerID=8YFLogxK
U2 - 10.1111/opo.12699
DO - 10.1111/opo.12699
M3 - Article
C2 - 32495395
AN - SCOPUS:85085901222
SN - 0275-5408
VL - 40
SP - 433
EP - 441
JO - Ophthalmic and Physiological Optics
JF - Ophthalmic and Physiological Optics
IS - 4
ER -
