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Fiona Stapleton, Simon C Lim, Micheal Knipe, Nitin Verma; New referrals to an Australian ophthalmic outpatient clinic. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6106.
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There are limited data on the patterns and quality of referrals to ophthalmic clinics in Australia. This study reports patient demographics, reason for referral and final diagnosis in new patients referred to the eye clinic at the Royal Hobart Hospital
Electronic medical records for new referrals attending the eye clinic at the Royal Hobart Hospital between January 1 2012 and April 30th 2012 were audited. Patient age, gender, index of relative social disadvantage (IRSD, based on postcode), referrer, reason for referral and final diagnosis (classified according to the International Classification of Disease codes (ICD-10)) were recorded. Concordance between reason for referral and final diagnosis was determined.
440 new patients presented during the study and 48% were female. Mean age was 47±27 years, and there was a bimodal distribution with peaks at 5 years and 65 years. The mean IRSD was 954±73. The most common referrals were for disorders of muscles, binocular movement, accommodation and refraction (16.2%), disorders of the lens (12.3%) and injury of eye and orbit (11.9%). Diabetes/diabetic retinopathy and glaucoma comprised 8.2% and 5.3% of new referrals respectively. Concordance analysis was performed for 366 patients with a valid referral letter. High concordance (80%<) was seen for diagnoses of disorders of the lens, glaucoma, diabetes, disorders of eyelid, lacrimal system and orbit, and congenital abnormalities. Poor concordance was seen for diagnoses of disorders of muscles, binocular movement, accommodation and refraction (63%) and for disorders of conjunctiva, and disorders of sclera, cornea, iris and ciliary body (55%). Referrals from optometrists and general practitioners showed high concordance with final diagnoses (92% and 82% respectively).
Analysis of current patient referral trends to an ophthalmic outpatient clinic provides valuable information in allocation of hospital resources and in improving quality of referrals.
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