Michigan Screening and Intervention for Glaucoma and Eye Health Through Telemedicine Program: First-Year Outcomes and Implementation Costs.
Michigan Screening and Intervention for Glaucoma and Eye Health Through Telemedicine Program: First-Year Outcomes and Implementation Costs.
复制标题
密歇根州通过远程医疗计划进行青光眼和眼健康筛查和干预：第一年成果和实施成本。
DOI：
10.1016/j.ajo.2023.02.026
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发表时间：
2023
影响因子：
4.2
通讯作者：
Woodward,MariaA
中科院分区：
文献类型：
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作者：
Newman-Casey,PaulaAnne;Niziol,LeslieM;Elam,AngelaR;Bicket,AmandaK;Killeen,Olivia;John,Denise;Wood,SarahDougherty;Musch,DavidC;Zhang,Jason;Johnson,Leroy;Kershaw,Martha;Woodward,MariaA
密歇根州通过远程医疗筛查和干预青光眼和眼睛健康（MI-SIGHT）计划旨在吸引青光眼高危人群;我们评估第一年的结果和成本。设计临床队列研究。方法从密歇根州的一家免费诊所和一家联邦合格的健康中心招募≥ 18岁的参与者。门诊眼科技术人员收集人口统计学信息、视功能、眼部健康史，测量视力、屈光度、眼压、角膜厚度、瞳孔，并拍摄散瞳眼底照片和视网膜神经纤维层光学相干断层扫描。数据由远程眼科医生解释。在随访期间，技术人员分享了眼科医生的建议，分发了低成本的眼镜，并收集了参与者的满意度。主要结果指标为眼病患病率、视功能、项目满意度和费用。观察到的患病率与全国疾病患病率进行比较，使用z检验的比例。结果在1171名参与者中，平均年龄为55岁（SD 14.5岁），38%为男性，54%为黑人，34%为白色，10%为西班牙裔，33%的人受教育程度低于或等于高中，70%的人年收入<30，000美元。视力损害患病率为10.3%（全国平均2.2%），青光眼和疑似青光眼患病率为24%（全国平均9%），黄斑变性患病率为2.0%（全国平均1.5%），糖尿病视网膜病变患病率为7.3%（全国平均3.4%）（P<0.01）。0001）。71%的参与者获得了低成本的眼镜，41%的参与者接受了眼科随访，99%的参与者对该计划感到满意或非常满意。开办费用为103 185美元;每个诊所的经常性费用为248 103美元。结论：低收入社区诊所的远程眼科疾病检测项目有效地识别了高发病率的病理。
Purpose The Michigan Screening and Intervention for Glaucoma and Eye Health Through Telemedicine (MI-SIGHT) program aims to engage people who are at high risk of glaucoma; we assess first-year outcomes and costs. Design Clinical cohort study. Methods Participants≥ 18 years of age were recruited from a free clinic and a federally qualified health center in Michigan. Ophthalmic technicians in the clinics collected demographic information, visual function, ocular health history, measured visual acuity, refraction, intraocular pressure, pachymetry, pupils, and took mydriatic fundus photographs and retinal nerve fiber layer optical coherence tomography. Data were interpreted by remote ophthalmologists. During a follow-up visit, technicians shared ophthalmologist recommendations, dispensed low-cost glasses, and collected participant satisfaction. The primary outcome measures were prevalence of eye disease, visual function, program satisfaction, and costs. Observed prevalence was compared with national disease prevalence rates using z tests of proportions. Results Among 1171 participants, the average age was 55 years (SD 14.5 years), 38% were male, 54% identified as Black, 34% as White, 10% as Hispanic, 33% had less than or equal to a high school education, and 70% had an annual income< $30,000. The prevalence of visual impairment was 10.3%(national average 2.2%), glaucoma and suspected glaucoma 24%(national average 9%), macular degeneration 2.0%(national average 1.5%), and diabetic retinopathy 7.3%(national average 3.4%)(P<. 0001). Seventy-one percent of participants received low-cost glasses, 41% were referred for ophthalmology follow-up, and 99% were satisfied or very satisfied with the program. Startup costs were $103,185; recurrent costs were $248,103 per clinic. Conclusions Telemedicine eye disease detection programs in low-income community clinics effectively identify high rates of pathology.