A Systematic Analysis of the Impact of an Ambulatory Ophthalmology Urgent Care Clinic
Importance A same-day ophthalmic urgent care clinic can provide efficient eye care, a rich educational environment, and can improve patient experience. Objective The aim of this study was to systematically evaluate volume, financial impact, care metrics, and the breadth of pathology of ur...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Thieme Medical Publishers, Inc.
2022-07-01
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| Series: | Journal of Academic Ophthalmology |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1741464 |
| _version_ | 1818028664807227392 |
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| author | Sally S.E. Park Rohin Vij Jeff Wu Bryan Zarrin Jee-Young Moon Jason Oliveira Jeffrey S. Schultz Anurag Shrivastava |
| author_facet | Sally S.E. Park Rohin Vij Jeff Wu Bryan Zarrin Jee-Young Moon Jason Oliveira Jeffrey S. Schultz Anurag Shrivastava |
| author_sort | Sally S.E. Park |
| collection | DOAJ |
| description | Importance A same-day ophthalmic urgent care clinic can provide efficient eye care, a rich educational environment, and can improve patient experience.
Objective The aim of this study was to systematically evaluate volume, financial impact, care metrics, and the breadth of pathology of urgent new patient encounters based on their site of initial presentation.
Design, Setting, and Participants A retrospective analysis was performed on consecutive urgent new patient evaluations in our same-day triage clinic at the Henkind Eye Institute at Montefiore Medical Center between February 2019 and January 2020. The cohort of patients who presented directly to this urgent care clinic were referred to as the “TRIAGE” group. Patients who initially presented to an emergency department (ED), and were subsequently referred to our triage clinic, are referred to as the “ED + TRIAGE” group.
Main Outcomes and Measures Visits were evaluated on a variety of metrics, including diagnosis, duration, charge, cost, and revenue. Furthermore, return to the ED or inpatient admission was documented.
Results Of 3,482 visits analyzed, 2,538 (72.9%) were in the “TRIAGE” group. Common presenting diagnoses were ocular surface disease (n = 486, 19.1%), trauma (n = 342, 13.5%; most commonly surface abrasion n = 195, 7.7%), and infectious conjunctivitis (n = 304, 12.0%). Patients in the “TRIAGE” group, on average, were seen 184.6% faster (158.2 vs. 450.2 minutes) than patients in the “ED + TRIAGE” group (p < 0.001). The “ED + TRIAGE” group were furthermore found to generate 442.1% higher charges ($870.20 vs. 4717.70) and were associated with 175.1% higher cost ($908.80 vs. 330.40) per patient. The hospital was found to save money when noncommercially insured patients with ophthalmic complaints presented to the triage clinic instead of the ED. Patients seen in the triage clinic had a low rate of readmission to the ED (n = 42, 1.2%).
Conclusions and Relevance A same-day ophthalmology triage clinic provides efficient care, while providing a rich learning environment for residents. Less wait time with direct access to subspecialist care can help improve quality, outcome, and satisfaction metrics. |
| first_indexed | 2024-12-10T05:07:24Z |
| format | Article |
| id | doaj.art-84ed73ba2abc450a8d06f41f29ea25c1 |
| institution | Directory Open Access Journal |
| issn | 2475-4757 |
| language | English |
| last_indexed | 2024-12-10T05:07:24Z |
| publishDate | 2022-07-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Journal of Academic Ophthalmology |
| spelling | doaj.art-84ed73ba2abc450a8d06f41f29ea25c12022-12-22T02:01:11ZengThieme Medical Publishers, Inc.Journal of Academic Ophthalmology2475-47572022-07-011402e229e23710.1055/s-0041-1741464A Systematic Analysis of the Impact of an Ambulatory Ophthalmology Urgent Care ClinicSally S.E. Park0Rohin Vij1Jeff Wu2Bryan Zarrin3Jee-Young Moon4Jason Oliveira5Jeffrey S. Schultz6Anurag Shrivastava7Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, New YorkDepartment of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New YorkDepartment of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, New YorkDepartment of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, New YorkDepartment of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New YorkDepartment of Financial Planning and Analysis, Montefiore Health System, Tarrytown, New YorkDepartment of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, New YorkDepartment of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, New YorkImportance A same-day ophthalmic urgent care clinic can provide efficient eye care, a rich educational environment, and can improve patient experience. Objective The aim of this study was to systematically evaluate volume, financial impact, care metrics, and the breadth of pathology of urgent new patient encounters based on their site of initial presentation. Design, Setting, and Participants A retrospective analysis was performed on consecutive urgent new patient evaluations in our same-day triage clinic at the Henkind Eye Institute at Montefiore Medical Center between February 2019 and January 2020. The cohort of patients who presented directly to this urgent care clinic were referred to as the “TRIAGE” group. Patients who initially presented to an emergency department (ED), and were subsequently referred to our triage clinic, are referred to as the “ED + TRIAGE” group. Main Outcomes and Measures Visits were evaluated on a variety of metrics, including diagnosis, duration, charge, cost, and revenue. Furthermore, return to the ED or inpatient admission was documented. Results Of 3,482 visits analyzed, 2,538 (72.9%) were in the “TRIAGE” group. Common presenting diagnoses were ocular surface disease (n = 486, 19.1%), trauma (n = 342, 13.5%; most commonly surface abrasion n = 195, 7.7%), and infectious conjunctivitis (n = 304, 12.0%). Patients in the “TRIAGE” group, on average, were seen 184.6% faster (158.2 vs. 450.2 minutes) than patients in the “ED + TRIAGE” group (p < 0.001). The “ED + TRIAGE” group were furthermore found to generate 442.1% higher charges ($870.20 vs. 4717.70) and were associated with 175.1% higher cost ($908.80 vs. 330.40) per patient. The hospital was found to save money when noncommercially insured patients with ophthalmic complaints presented to the triage clinic instead of the ED. Patients seen in the triage clinic had a low rate of readmission to the ED (n = 42, 1.2%). Conclusions and Relevance A same-day ophthalmology triage clinic provides efficient care, while providing a rich learning environment for residents. Less wait time with direct access to subspecialist care can help improve quality, outcome, and satisfaction metrics.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1741464ophthalmologyresidentssubspecialtytriageurgent careemergency department |
| spellingShingle | Sally S.E. Park Rohin Vij Jeff Wu Bryan Zarrin Jee-Young Moon Jason Oliveira Jeffrey S. Schultz Anurag Shrivastava A Systematic Analysis of the Impact of an Ambulatory Ophthalmology Urgent Care Clinic Journal of Academic Ophthalmology ophthalmology residents subspecialty triage urgent care emergency department |
| title | A Systematic Analysis of the Impact of an Ambulatory Ophthalmology Urgent Care Clinic |
| title_full | A Systematic Analysis of the Impact of an Ambulatory Ophthalmology Urgent Care Clinic |
| title_fullStr | A Systematic Analysis of the Impact of an Ambulatory Ophthalmology Urgent Care Clinic |
| title_full_unstemmed | A Systematic Analysis of the Impact of an Ambulatory Ophthalmology Urgent Care Clinic |
| title_short | A Systematic Analysis of the Impact of an Ambulatory Ophthalmology Urgent Care Clinic |
| title_sort | systematic analysis of the impact of an ambulatory ophthalmology urgent care clinic |
| topic | ophthalmology residents subspecialty triage urgent care emergency department |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1741464 |
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