Quality of care in cataract surgery cases experiencing post-operative complications with co-managed care.
BACKGROUND
The quality of co-managed services and the ability of community optometrists to diagnose complications following cataract surgery were investigated in a previous study of 2,458 cases. Questions were raised about the quality of co-managed care in 50 of the cases; this study evaluates the care received by these patients.


METHODS
Medical records for 44 cases (6 cases could not located) were reviewed to determine whether community optometrists diagnosed post-surgical complications and whether cases were effectively managed. All reviews were performed by two optometrists and an ophthalmologist. Six cases were excluded because of no complication or attribution to underlying disease.


RESULTS
In 34 of the 38 remaining cases (89.5%), co-management was successful in diagnosing complications and in managing the patient to maximize vision function. 99.8% (2,454 of 2,458) of co-managed cases contained evidence that the optometrists provided high quality post-operative care and were able to diagnose complications. Using physician evaluations as the standard, the sensitivity of detection of complications by optometrists was 95.9% and the specificity was 99.5%.


CONCLUSIONS
Co-managing optometrists provide quality care and can diagnose post-operative complications.
Revicki
D A
DA
Battelle Centers for Public Health Research and Evaluation, Arlington, VA, USA.
Poe
M L
ML
D000368:Aged; D002387:Cataract Extraction / Q000009:adverse effects*; D002983:Clinical Competence; D003266:Continuity of Patient Care / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D009657:North Carolina; D009885:Ophthalmology / Q000592:standards; D009907:Optometry / Q000592:standards*; D011182:Postoperative Care / Q000592:standards*; D011183:Postoperative Complications / Q000175:diagnosis*; D011787:Quality of Health Care / Q000592:standards*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014792:Visual Acuity