Tuulonen A, Kataja M, Syvnen U, et al.
眼科 患者 地点
目的：该报告描述了Tays眼科中心实施的战略背后的概念，以改善护理的获取和提高效率。方法：该策略是在院区决定在2012年建成一所新眼科医院后于2009年制定的。实施了以下原则：（i）确定大量患者群体：“四大”眼病占患者就诊和费用的70％：年龄相关性黄斑变性（AMD），青光眼，视网膜疾病和白内障; （ii）根据永久性视力残疾风险对患者护理进行分层和优先排序; （iii）为低风险患者提供标准化服务; （iv）最大限度地提高效率;和（v）共享护理。 2011-2015年报告了新策略对护理获得和效率的影响。结果：在2011-2015年，提供的服务总数增加了46％，而工作贡献增加了15％。转诊数量增加了76％，门诊病人数增加了2.5倍。同时，延迟随访的次数减少到了零。年龄相关性黄斑变性（AMD）注射治疗增加1.8倍。然而，在年龄相关性黄斑变性（AMD）注射每年增加50％之后，2014年达到瓶颈期，在2014-2015年下降了3％，但治疗适应症没有改变。在2016年初，注射量开始增加（与2015年相比增加了9％）。手术总次数增加98％。白内障手术年增长率增加了64％，双侧手术从11％增加到39％。结论：修订的手术操作概念和新设施以及工作贡献增加15％，导致总体效率增加了46％，改善了护理的获取，清除了延迟服务。继续努力以进一步改进成本效益护理，并确定适当的服务水平。
PURPOSE:The report describes the concepts behind procedures implemented in Tays Eye Centre to enable improved access to care and improved productivity.METHODS:The strategy was developed in 2009 after hospital district decided to construct a new eye hospital which was opened in 2012. The following principles were implemented: (i) identification of high-volume patient groups: the 'big four' eye diseases accounting for 70% of patient visits and costs: age-related macular degeneration (AMD), glaucoma, retinal diseases and cataract; (ii) stratification and prioritization of patient care based on risk of permanent visual disability; (iii) standardization of services for low-risk patients; (iv) maximization of productivity; and (v) shared care. The impact of the new strategy on access to care and productivity is reported for years 2011-2015.RESULTS:In 2011-2015, the total number of services provided increased 46% while the work contribution increased 15%. The number of referrals increased 76% and the number of outpatient appointments increased 2.5-fold. Simultaneously, the number of delayed follow-up visits decreased to zero. Age-related macular degeneration (AMD) injections increased 1.8-fold. However, after 50% yearly increase in Age-related macular degeneration (AMD) injections, a plateau was reached in 2014 with a 3% decline in 2014-2015 with no changes in treatment indications. In the beginning of 2016, the number of injections has started to increase again (+9% compared to 2015). The total number of surgical procedures increased 98%. The annual number of cataract surgeries increased 64% and bilateral surgeries from 11% to 39%.CONCLUSION:Revised operational concepts and new facilities together with a 15% increase in work contribution led to a 46% increase in overall productivity, improved access to care and the clearance of delayed services. Efforts continue to further refine cost-effective care and to define the appropriate levels of services.