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Arjun J. Dirghangi, Syeda T. Hamadani, Haiming Du, Peter A. Netland, Sarwat Salim; Patients' Addressed Complaints in Outpatient Glaucoma and Comprehensive Ophthalmology Services. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5536.
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The purpose of this study is to examine gaps in health communication by comparing the odds of patient complaints being addressed in the medical record by outpatient general and subspecialty services.
A retrospective review of medical records for randomly-selected medically-managed patients was conducted to compare patients’ addressed complaints in both comprehensive ophthalmology and glaucoma services in an academic ophthalmology setting.
A total of 101 patients were studied and found to be well-matched by treating service for age, gender, and ethnicity. Glaucoma service patients had greater odds of being follow-up patients than comprehensive service patients (OR=5.282, P=0.000), and lesser odds of presenting with any acute complaints (OR=.261, P=0.009). For patients presenting with complaints, the rate and odds of all concerns being addressed in the assessment and plan were significantly lower in the glaucoma service versus comprehensive service (16.67% versus 63.89%, respectively, OR=.113, P=0.000). Using a multiple logistic regression model to adjust for visit type, age, gender, ethnicity, number of complaints, and treating service, only treating service was found to be significantly associated with all patient complaints being addressed by the treating physician. Using this model, for patients with complaints, the odds of all complaints being addressed in the charted encounter note remained significantly lower (by 92.5%) for patients of glaucoma specialists versus comprehensive ophthalmologists, with an adjusted odds ratio (AOR) of .075 (95% CI: .0189-.298, P=0.000).
In this study, compared to glaucoma specialists, patients seen by comprehensive ophthalmologists were more likely to have all their concerns addressed in the charted encounter note. Patients seen by glaucoma specialists were more likely to be seen in follow-up appointments and less likely to voice acute complaints, though neither visit type nor number of complaints were found to be significantly associated with all complaints being addressed. As patient-centered outcomes and patient perceptions become increasingly-adopted metrics for physician performance, the study findings show an important opportunity to improve physician-patient communication regarding patient concerns, particularly for subspecialty services.
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