Eye care utilisation patterns in a rural county in Ireland: implications for service delivery
a Dana Center for Preventive Ophthalmology,
Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland,
USA, b Western
Health Board, Roscommon, Ireland
Correspondence to: Dr Sheila West, Johns Hopkins University, Wilmer Eye Institute, Room 129, 600 North Wolfe Street, Baltimore, MD 21287-9019, USA.
Accepted for publication 28 May 1997
AIMS/BACKGROUND
This investigation determined eye
care utilisation patterns in a rural county in Ireland. Population
based estimates of visual impairment and glaucoma were available, so
the two studies will optimise planning for eye care services for the county.
METHODSRoscommon has a population of 55 000
served by one ophthalmologist and two optometrists. Data were collected
on all outpatient visits for all providers for a 3 month period.
Information was abstracted on demographics, presenting and final
diagnoses. Expected number of visits for glaucoma were calculated using
the population structure and rates of glaucoma, and assuming one visit
per year per glaucoma patient.
RESULTS1398 patients had a total of 1442 visits
in 3 months. A third of the visits were to optometrists, and all but 21 visits were for normal eye examinations or glasses. The majority of
children aged less than 16 years, and people older than 60 years were
seen by the ophthalmologist. Among children, 81% of all visits were to
the ophthalmologist and 92% were classified as a normal examination. Only an estimated 188 visits per year for glaucoma were observed, compared with 1100 expected.
CONCLUSIONIn this rural county, many of the
visits to the ophthalmologist were for normal eye examination,
particularly among children. Screening algorithms which would free the
ophthalmologist to see more complicated problems could be considered.
There is an underutilisation of services by glaucoma patients. Reasons
for this are described.
© 1997 by British Journal of Ophthalmology
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