Abstract
Purpose :
To evaluate the Clínica Esperanza Ophthalmology Clinic, a student-run free ophthalmology teaching clinic established in fall 2020 to treat uninsured patients in southern New England.
Methods :
The ophthalmology clinic operates monthly under a novel clinic-within-a-clinic model wherein it exists as a subsidiary and uses the infrastructure of Clínica Esperanza, a free clinic for uninsured, Spanish-speaking patients. A mixed methods program evaluation and a retrospective chart review from April 2021 through November 2022 were performed and analyzed using descriptive statistics.
Results :
The ophthalmology clinic obtained a tonometer, slit lamp, indirect ophthalmoscope, condensing lenses, and dilating drops with a budget of $2934 through grant applications, donation solicitation, and vendor discount negotiation. Two volunteer ophthalmologists and 17 medical students worked in the clinic. Qualitative strengths included low operational overhead and student education. Qualitative challenges included long length of patient encounters and resultantly, low patient volumes.
Of 49 patients treated, four (4/49, 8%) were followed longitudinally. Patient age ranged from 25 to 88 years, with a median of 47 years. Spanish was patients’ most common first language (46/53, 88%). Of 90 scheduled encounters, slightly more than half were completed (53/90, 59%); the remaining (37/90, 41%) were either canceled or no shows. Dry eye was the most prevalent primary diagnosis among all completed encounters (15/53, 28%), followed by pterygium (7/53, 13%), diabetic retinopathy (6/53, 11%), glaucoma (4/53, 8%), and cataracts (4/53, 8%). Prescriptions were given at most encounters (41/53, 77%); the most prescribed medication was artificial tears (34/53, 64%). About half of all encounters resulted in patient enrollment in a free insurance program and in a referral to a hospital-based ophthalmology practice (25/53, 47%); most referrals were for refraction (18/25, 72%), followed by glaucoma (4/25, 16%) and cataract evaluation (3/25, 12%).
Conclusions :
As a teaching clinic, the Ophthalmology Clinic at Clínica Esperanza supplements existing free clinic operations and contributes to meeting an unmet public health need among its region’s most vulnerable patients. The clinic-within-a-clinic model and the financial strategies employed herein may be useful in establishing similar programs.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.