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CC BY-NC-ND 4.0 · Journal of Academic Ophthalmology 2022; 14(02): e229-e237
DOI: 10.1055/s-0041-1741464
Research Article

A Systematic Analysis of the Impact of an Ambulatory Ophthalmology Urgent Care Clinic

Sally S.E. Park 
1   Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, New York
,
Rohin Vij
2   Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
,
Jeff Wu
1   Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, New York
,
Bryan Zarrin
1   Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, New York
,
Jee-Young Moon
2   Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York
,
Jason Oliveira
3   Department of Financial Planning and Analysis, Montefiore Health System, Tarrytown, New York
,
Jeffrey S. Schultz
1   Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, New York
,
Anurag Shrivastava
1   Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, New York
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Abstract

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.

Keywords

ophthalmology - residents - subspecialty - triage - urgent care - emergency department

Disclosures

None.


Supplementary Material



Publication History

Received: 22 June 2021

Accepted: 12 October 2021

Article published online:
30 September 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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