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Monica M Michelotti, Jennifer S Weizer, Joshua D Stein, Simon P Kelly, Declan W Flanagan, Anne C Odergren, Paul P Lee, Melanie Hingorani; Comparing Quality Performance Measures Publicly Reported by Ophthalmic Organizations. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5586.
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There is increasing global interest in evaluating health care quality by measuring clinical and patient-reported outcomes in all specialties and publishing these outcomes for the medical field and for the lay public. Several ophthalmic provider groups now publicly report performance, but the metrics used differ. Better understanding may advance work in improving the care of ophthalmic patients.
An online search for quality, especially outcomes, data for international ophthalmic institutions was performed; results were compared with published outcomes and performance data. The World Association of Eye Hospitals provided additional unpublished hospital-specific measures. Data were available from Aravind Eye Hospital, Cole Eye Institute, European Registry of Quality Outcomes for Cataract and Refractive Surgery, University of Michigan W.K. Kellogg Eye Center, Massachusetts Eye and Ear Infirmary, Moorfields Eye Hospital, Singapore National Eye Center, and St Erik’s Eye Hospital.
Multiple institutions reported similar complication rates for ophthalmic surgery. All measured wound infection rates and 30 day unplanned reoperation rates. Endophthalmitis rates after cataract surgery ranged from 0.00-0.09% (n=8). Most institutions reported either postoperative visual acuity (n=6) or difference in refraction from target after cataract surgery (n=4). The most commonly reported outcome was best-corrected visual acuity better than or equal to 20/40 (range 84-100%, n=3). Variance in reporting postoperative visual acuity outcomes occurred in the choice of measuring final or change in visual acuity, best- or uncorrected visual acuity, and timing of measurements. Eight institutions reported 22 cataract surgery outcomes and three reported rates for only uncomplicated patients. Subspecialty outcomes demonstrated similar trends. Differences in timing and exclusion criteria limited direct comparisons.
Because published outcomes and quality of care data in ophthalmology varies by institution, understanding and identifying metrics that all might agree upon is crucial. Comparing outcomes by international ophthalmic institutions can provide insight for assessment for a broader and lay audience, helping ophthalmologists benchmark services in the timely quest for quality and safety.
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