Systematic review of the appropriateness of eye care delivery in eye care practice.

Kam Chun Ho, Fiona Stapleton, Louise Wiles, Peter Hibbert, Sally Alkhawajah, Andrew White, Isabelle Jalbert

Journal: BMC health services research 2019;19(1):646

PMID: 31492128

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Abstract

BACKGROUND

Health care systems are continually being reformed, however care improvement and intervention effectiveness are often assumed, not measured. This paper aimed to review findings from published studies about the appropriateness of eye care delivery, using existing published evidence and/or experts' practice and to describe the methods used to measure appropriateness of eye care.

METHODS

A systematic search was conducted using Medline, Embase and CINAHL (2006 to September 2016). Studies reporting the processes of eye care delivery against existing published evidence and/or experts' practice were selected. Data was extracted from published reports and the methodological quality using a modified critical appraisal tool. The primary outcomes were percentage of appropriateness of eye care delivery. This study was registered with PROSPERO, reference CRD42016049974.

RESULTS

Fifty-seven studies were included. Most studies assessed glaucoma and diabetic retinopathy and the overall methodological quality for most studies was moderate. The ranges of appropriateness of care delivery were 2-100% for glaucoma, 0-100% for diabetic retinopathy and 0-100% for other miscellaneous conditions. Published studies assessed a single ocular condition, a sample from a single centre or a single domain of care, but no study has attempted to measure the overall appropriateness of eye care delivery.

CONCLUSIONS

These findings indicated a wide range of appropriateness of eye care delivery, for glaucoma and diabetic eye care. Future research would benefit from a comprehensive approach where appropriateness of eye care is measured across multiple conditions with a single methodology, to guide priorities within eye care delivery and monitor quality improvement initiatives.

Address: School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW, 2052, Australia.; Eye Health, Injury Division, The George Institute for Global Health, Sydney, Australia.; Faculty of Medicine and Health Sciences, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.; Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.; Optometry and Vision Science Department, King Saud University, Riyadh, Saudi Arabia.; Save Sight Institute, University of Sydney, Westmead Hospital, Sydney, New South Wales, Australia.; Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Westmead Hospital, Sydney, New South Wales, Australia.; School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW, 2052, Australia. [email protected].

DOI: 10.1186/s12913-019-4493-3

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MeSH Terms: Delivery of Health Care, Eye Diseases, Female, Humans, Male, Office Visits, Program Evaluation, Quality of Health Care