Utilization of Ophthalmology-Specific Emergency Department Services.
OBJECTIVE
To describe utilization trends of an ophthalmology-specific emergency department (ED).


METHODS
Prospective cohort study of new patients presenting in the ophthalmology ED for at least a 30-day period in the spring of each year for five consecutive years (2010-14) at a university referral center. A data form, including information about the ED visit and patient demographics, was included in each patient chart. Data were analyzed with Pearson chi-square test and multiple logistic regression.


RESULTS
A total of 5323 chart data forms were completed. An average of 42.2 new patients per day presented to the ophthalmology ED. Most common diagnoses were viral conjunctivitis (8.7%), dry eye syndrome (6.6%), and corneal abrasion (6.6%). Non-emergent visits accounted for 35.8% of surveys completed. Factors associated with non-emergent visits included female gender, age 65 years or older, weekday visits, and patient symptom duration greater than one week (p < 0.0001 for each factor). When compared to all other insurance categories combined, patients who were members of the regional public assistance program were the most likely to present with a non-emergency (48.5% versus 34.9%, p < 0.001), while Workers' Compensation patients were least likely to present with a non-emergency (16% versus 36.5%, p < 0.001).


CONCLUSIONS
Over one-third of new patient visits were non-emergent. Factors predictive of non-emergent patient visits were female gender, age 65 years or older, duration of symptoms greater than one week, weekday visits, and the form of insurance coverage.
a Department of Ophthalmology , Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami , FL , USA.
Jayanth
J
Sridhar
a Department of Ophthalmology , Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami , FL , USA.
Ryan F
RF
Isom
a Department of Ophthalmology , Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami , FL , USA.
Joyce C
JC
Schiffman
a Department of Ophthalmology , Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami , FL , USA.
Luz
L
Ajuria
a Department of Ophthalmology , Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami , FL , USA.
Laura C
LC
Huang
a Department of Ophthalmology , Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami , FL , USA.
Daniel
D
Gologorsky
a Department of Ophthalmology , Bascom Palmer Eye Institute, University of Miami Miller School of Medicine , Miami , FL , USA.
James T
JT
Banta
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004630:Emergencies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005128:Eye Diseases / Q000628:therapy*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data*; D009885:Ophthalmology; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D055815:Young Adult
Conjunctivitis; eye emergency; foreign body; ophthalmic emergency; utilization