COMPREHENSIVE EVALUATION OF THE EFFECTIVENESS OF IMPLEMENTING A REGIONAL MODEL OF SPECIALIZED OPHTHALMOLOGICAL CARE FOR EYE INJURIES
Keywords:
eye injuries; ophthalmic care; regional model; performance assessment; healthcare organization; patient routing; telemedicine; quality of medical care.Abstract
Purpose. Comprehensive assessment of the effectiveness of the implementation of a regional model of special- ized ophthalmic care for eye injuries based on the analysis of medical, organizational and economic indicators to substantiate optimal approaches to organizing an ophthalmic service. Materials and Methods. The study was conducted in two stages in a region with a population of 1.8 mil- lion people: the control period (2019–2020, n = 1847) and the main period after the implementation of the model (2021–2023, n = 2156). Medical and statistical, sociological methods, expert assessment and economic analysis were used. The implemented model included the creation of a dispatch center for coordination, the organization of round-the-clock shifts, the development of routing protocols, and a system of telemedical consultations. Statistical processing was carried out in IBM SPSS Statistics 26.0. Results. The mean time from injury to ophthalmological examination decreased from 8.4 ± 3.7 to 3.2 ± 1.8 hours (p < 0.001). The proportion of patients seen within 3 hours increased from 28.3% to 67.8% (p < 0.001). The pro- portion of patients with visual acuity ≥ 0.5 after treatment increased from 58.4% to 73.2% (p < 0.001), monocular blindness decreased from 8.9% to 4.3% (p < 0.001). In patients with penetrating injuries, the complication rate decreased from 34.6% to 21.3% (HR = 0.62; 95%CI 0.48–0.79). Patient satisfaction increased from 67.3% to 88.7% (p < 0.001). The economic analysis demonstrated a positive cost-effectiveness ratio. Conclusions. The implementation of a comprehensive regional model has significantly improved the timeli- ness, accessibility and quality of ophthalmic care for eye injuries, as evidenced by improved clinical outcomes, reduced complication rates and cost-effectiveness. The creation of a system of coordination, dispatching and tele- medicine consultations are key factors in the success of the model.
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