Eye-related Emergency Department Visits in the United States, 2010

Vaziri, Kamyar; Schwartz, Stephen G.; Flynn, Harry W.; Kishor, Krishna; Moshfeghi, Andrew A

doi:10.1016/j.ophtha.2015.10.032

Cited by 54 publications

(41 citation statements)

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“…Several common ocular conditions were not included in this study. Injuries such as orbital fractures, which are a common ED occurrence, especially in the elderly were not reported in the present study. Most likely, the search terms used in this study would not pick up orbital injuries.…”

Section: Discussionmentioning

confidence: 58%

“…While previous research has described the epidemiology of CCI in hospital‐based emergency departments, this is the first time this issue has been addressed at community based UCC. In this study, an injury to the cornea and/or conjunctiva was present in 0.8% of patients who presented to Urgent Care Centres (UCC) with about half of them presenting with a foreign body in the eye.…”

Section: Discussionmentioning

confidence: 99%

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Corneal and conjunctival injury seen in urgent care centres in Israel

Zimmerman

Shneor

Millodot

et al. 2019

Ophthalmic Physiologic Optic

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PurposeCorneal and conjunctival injuries (CCI) comprise a large portion of the cases presenting to hospital‐based emergency departments (ED) with ocular involvement. Urgent Care Centres (UCC) offer community based emergency care at lower cost than hospital‐based emergency departments (ED) and with greater temporal convenience than primary care office settings. While CCI prevalence and treatment at hospital‐based EDs has been well studied, this is the first report, to our knowledge, on CCI demographics and aetiology presenting to UCCs.MethodsThis retrospective study was approved by the institutional ethics committee. The setting is a UCC system in Israel, modelled on USA urgent care facilities, consisting of 17 branches at the time of the study. Electronic medical record data (between November 1, 2015 and October 31, 2016) of patients diagnosed with corneal disorder, foreign body or eye disorder were retrieved and reviewed for inclusion/exclusion criteria. Data collected included gender, age, chief complaint, diagnosis, treatment and discharge status (sent home or referred to ED). International Classification of Diseases, Ninth Revision (ICD‐9) codes were assigned to each record based on a review of all fields. UCC results were compared to all ED patients in Israel using data from a public report. Data were analysed by descriptive statistics and logistic regression analysis.ResultsOf the 602 074 charts screened, 4797 patients presented with CCI (0.8%). The average age was 32.6 ± 18.2 years and 71.3% were male. Among these, 26.4% were referred to the ED compared to 6.8% from the entire UCC cohort. ICD‐9 code Foreign body (FB) of the eye was the most common cause of CCI (56.5%) followed by the following ICD‐9 codes: trauma (18.1%), chemical in the eye (11.1%) and corneal disorder due to a contact lens (5.1%). Logistic regression analyses showed the following risk factors for ED referral: age (22–64), male gender, ICD‐9 code FB, work‐related injury and the presence of a clinical abrasion in the eye.ConclusionsThe aetiology of ocular injury at UCC is similar to previous studies of ED. Most CCI can be treated at UCC saving ED resources and underscores the importance of this mode of health care delivery in the overall health system.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Corneal and conjunctival injury seen in urgent care centres in Israel

Zimmerman

Shneor

Millodot

et al. 2019

Ophthalmic Physiologic Optic

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“…According to the US studies, approximately 1.5% to 3.4% of patients visiting the ED came for ophthalmic reasons 1,4 . Regarding eye-related ED visits, 41.2% were emergent and 44.3% of were nonemergent from 2006 to 2011 3 , and 23.0% were related for nonemergent ocular conditions from 2001 to 2014 according to another study 4 .…”

Section: Discussionmentioning

confidence: 99%

Eye-related Emergency Department Visits with Ophthalmology Consultation in Taiwan: Visual Acuity as an Indicator of Ocular Emergency

Kang

Tai

Lin

et al. 2020

Sci Rep

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to investigate the epidemiology of eye-related emergency department (eD) visits and to determine if visual acuity (VA) could be an indicator for determining the timing for managing ocular emergencies, we have conducted the retrospective study which included patients visited the eD for eye-related reasons and had received ophthalmology consultations at a referral center in Taiwan in 2015. Among 46,514 consultations, 5,493 were ophthalmology consultations (11.8%). After exclusion, 5,422 were eligible for analysis. Among them, 1,165 (21.5%) had not likely emergent diagnoses, 4,048 (74.7%) had likely emergent diagnoses, and 209 patients (3.9%) could not be determined. The logMAR VA was 0.31 ± 0.48, 0.66 ± 0.78, and 1.00 ± 0.94 in groups with not likely emergent, likely emergent, and undetermined diagnoses, respectively. Among all eye-related ED visits, 10.3% of patients received ophthalmologic intervention or were admitted to the ophthalmology ward. A LogMAR VA score of 0.45 (decimal equivalent of 0.4) had the highest discrimination power for identifying whether a patient needed ophthalmology intervention or admission to ophthalmology ward (area under the curve: 0.802, sensitivity: 0.800, specificity: 0.672). In our study, we found VA could be an indicator for determining the priority and time of ocular emergencies requiring ophthalmic intervention in patients visiting the ED for eye-related reasons. People often visit the emergency department (ED) first for some ocular diseases. The most commonly reported eye condition in the ED is conjunctivitis followed by corneal injury, eye pain, and hordeolum 1. Although the ED can offer rapid management of ocular problems, an excessive number of nonemergent eye-related visits may overcrowd the ED, and limit the resources available for real emergent ophthalmic and other medical issues 2. A US study reported that approximately half of all ocular ED visits were not related to emergent conditions 3. Informing patients on how to appropriately seek eye care was suggested 4. The cost of ED visits in Taiwan is covered by Taiwan's National Health Insurance, making Taiwan health care renowned for its low cost and overloaded services 5. The average treatment-associated expenditure and drug-associated expenditure for a single ED visit are NT$1,155

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“…On average, there were 10.36 monthly visits per optometrist. Analysis by practice setting revealed a higher rate among those in rural settings (12.56 ± 10.53 visits, 95% CI, 11.55-13.56) compared with urban set- Notes: Calculations based on data from Vaziri et al, 6 Channa et al, 7 and Stagg et al 8 Weighted average cost savings per incident: $860.57.…”

Section: Resultsmentioning

confidence: 99%

“…Average cost savings per ED visit avoided ($860) were calculated by subtracting the cost of office-based care from the ED-associated costs, weighted by frequency and cost per condition according to previous reports ( Table 2). [6][7][8] Costs of medications and follow-up examinations were excluded from the calculation of average cost.…”

Section: Measures and Data Collectionmentioning

confidence: 99%

Transformation Support Provided Remotely to a National Cohort of Optometry Practices

et al. 2019

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PURPOSE We describe the results of a practice transformation project conducted within a national cohort of optometry practices participating in the Southern New England Practice Transformation Network. METHODS Participants were 2,997 optometrists in 1,706 practices in 50 states. The multicomponent intervention entailed curriculum dissemination through a preexisting network of optometrists supported by specialized staff and resources, and data collection through a web portal providing real-time feedback. Outcomes included practices reporting data, urgent optometry visits for target conditions, and projected cost savings achieved by reducing emergency department (ED) use through increased provision of urgent care for conditions amenable to management in optometry practices. RESULTS Over 13 months, 69.9% of practices reported data for a mean of 6.7 months. Beginning with the fourth month, the number of urgent optometry visits increased steadily. Among reporting practices, the total cost savings were estimated at $152 million (176,703 ED visits avoided at an average cost differential of $860 per visit). Monthly projected cost savings per optometrist were substantially greater in rural vs urban practices ($10,800 vs $7,870; P <.001). CONCLUSIONS Technical assistance to promote practice transformation can be provided remotely and at scale at low per-practice cost. Through the provision of timely, easily accessed ambulatory care, optometrists can improve the patient experience and reduce ED use, thereby reducing costs. The cost savings opportunities are immense because of the large volume and high expense of ED visits for ocular conditions that might otherwise be managed in ambulatory optometry practices.

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Eye-related Emergency Department Visits in the United States, 2010

Abstract: 2016-03-19T19:12:06

Cited by 54 publications

References 1 publication

Corneal and conjunctival injury seen in urgent care centres in Israel

Corneal and conjunctival injury seen in urgent care centres in Israel

Eye-related Emergency Department Visits with Ophthalmology Consultation in Taiwan: Visual Acuity as an Indicator of Ocular Emergency

Transformation Support Provided Remotely to a National Cohort of Optometry Practices

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