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Daniel Gologorsky, Joyce C Schiffman, Luz Ajuria, James Banta; Utilization of Ophthalmology-Specific Emergency Department Services: A Prospective Study. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1383.
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To describe utilization trends at an ophthalmology-specific emergency department.
This is a prospective study involving a survey completed by the physician at the end of each new patient visit at the Bascom Palmer Eye Institute emergency department. The survey was included in the chart of every new patient presenting to the emergency department for a 1-month period each year from 2010-2014. The study included 5,325 surveys completed by treating staff and physicians during the study period. Surveys included information on the date, time of day, patient age and gender, duration of symptoms, insurance status, preliminary diagnosis, time to follow-up appointment, and whether the physician considered the visit an ophthalmic emergency. All data were analyzed using student’s t-test and Pearson chi-squared test.
An average of 45.6 new patients per day (range 26-63) presented to the emergency department. Most common diagnoses included viral conjunctivitis (9.2%), dry eye syndrome (7.2%), and corneal abrasion (5.9%). Non-emergent visits accounted for 32.8% of visits. Female patients and patients with age of 65 years or older were statistically more likely to present with non-emergencies (p < 0.001). Patients presenting on the weekend were significantly more likely to be presenting with an ophthalmic emergency than those presenting during weekdays (74.1% versus 65.6%, p < 0.001). Patients insured under the regional public assistance program were more likely to present with non-emergencies than patients of all other insurance statuses (p < 0.001). Patients with symptom duration of greater than 1 week were significantly more likely to present with non-emergencies (p < 0.001).
Over one-third of new patient visits to the emergency department were non-emergent. Factors predictive of non-emergent patient visits were female gender, age of 65 years or older, duration of symptoms greater than one week, weekday visits, and regional public assistance insurance.
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