title: Coordination of outreach eye services in remote Australia.
abstract: BACKGROUND
  This paper aims to describe models for service integration between ophthalmology and optometry when conducting outreach eye services. The effect of good coordination on clinical activity and cost-effectiveness is examined.
  
  
  METHODS
  Cross-sectional case study based on remote outreach ophthalmology services in Australia.
  
  
  METHODS
  Key stake-holders from eye services in nine outreach regions participated in the study.
  
  
  METHODS
  Semistructured interviews were conducted to perform a qualitative assessment of outreach eye services' levels of coordination. Records of clinical activity were used to statistically compare the effects of good coordination.
  
  
  METHODS
  Clinical activity (surgery and clinic consultation rates), waiting times and costs per attendance. Surgical case rate being the proportion of surgery that results from a clinic.
  
  
  RESULTS
  Service integration between optometry and ophthalmology resulted in an increased surgical case rate for ophthalmology clinics (R(2) = 0.57). There were trends towards increased clinical activity and reduced waiting times, and costs/attendance were stable.
  
  
  CONCLUSIONS
  Coordination of eye services with better integration of ophthalmology and optometry roles may improve efficiency of services for patients. Coordination of eye services has multiple facets including facilitating engagement with the local community, eye professions and health facilities. The varied roles of eye health coordination require further definition and appropriate funding.
authors.affiliation: Indigenous Eye Health Unit, Melbourne School of Population Health, University of Melbourne McKinsey and Co., Melbourne, Victoria, Australia. angus.turner@gmail.com
authors.forename: Angus W
authors.initials: AW
authors.lastname: Turner
authors.forename: Will J
authors.initials: WJ
authors.lastname: Mulholland
authors.forename: Hugh R
authors.initials: HR
authors.lastname: Taylor
mesh_terms: D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D005128:Eye Diseases / Q000175:diagnosis / Q000628:therapy; D017048:Health Care Costs; D006297:Health Services Accessibility / Q000458:organization & administration; D006303:Health Services, Indigenous / Q000458:organization & administration*; D006801:Humans; D008507:Medically Underserved Area; D009313:National Health Programs / Q000458:organization & administration; D015876:Northern Territory; D013508:Ophthalmologic Surgical Procedures; D009885:Ophthalmology / Q000458:organization & administration*; D009907:Optometry / Q000458:organization & administration*; D010043:Outcome and Process Assessment, Health Care; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D010349:Patient Compliance; D011320:Primary Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D014850:Waiting Lists