Abstract
Met de toenemende zorgvraag en stijgende zorgkosten is ook taakherschikking binnen de oogzorg in Nederland een thema geworden. Er bestaat echter nauwelijks onderzoek naar de taakverdeling binnen de eerstelijns oogzorg, en meer specifiek wat de rol van de eerstelijns optometrist hierin zou kunnen zijn. In dit artikel is met behulp van patiënten-data van huisartsen en optometristen het substitutiepotentieel van de optometrist geschat voor een aantal aandoeningen die door enkele oogartsen en optometristen als ‘substitueerbaar’ zijn beoordeeld. Hieruit blijkt dat de optometrist jaarlijks potentieel 207.000 patiënten zou kunnen opvangen die anders door huisartsen geconsulteerd zouden zijn. De optometrist kan eveneens patiënten onderzoeken en adviseren die via de huisarts veelal naar de duurdere tweedelijns oogarts worden verwezen. Het kan hierbij in theorie om potentieel 21.000 patiënten gaan. De resultaten van dit onderzoek moeten vooralsnog met grote voorzichtigheid worden geïnterpreteerd. Zo is onder meer alleen een beperkte lijst van substitueerbare oogaandoeningen, door een beperkt aantal experts, beoordeeld. Daarnaast waren de aandoeningen-classificaties uit de gebruikte datasets vaak niet vergelijkbaar. Gegeven deze beperkingen, levert dit onderzoek een bijdrage aan de schatting hoe de optometrist in Nederland potentieel substitutie binnen de oogzorg kan bewerkstelligen.
English:
In recent years tasks reallocation between professions within Dutch eye care has been gaining importance in health policy, due to a higher demand for medical care and increasing financial costs. Empirical research focusing on the (potential) role of optometrists concerning task substitution barely exists, however. The aim of this study is to indicate the ‘substitution potential’ of optometrists within the eye care system. Based on patient-data of optometrists and general practitioners we estimated the substitution potential for a number of eye diseases. These diseases were judged as ‘substitutable’ according to two ophthalmologists and four optometrists. Results show that an annual shift of up to 207,000 general practitioner patients to the optometrist is possible, and up to 21,000 ophthalmologist patients can be prevented in case general practitioners refer patients with eye problems to the optometrist instead of the ophthalmologist. Our analysis estimated the potential pivotal volume taking by optometrists through task substitution within Dutch eye care. Results need to be interpreted carefully, however. A number of limitations have to be taken into account: (1) the list of potential substitutable’ eye diseases was assessed by only six experts, and (2) statistics on a limited number of eye diseases were available or comparable in datasets of general practice and optometrist practices. This study primarily provides a conceptual method to explore what volumes optometrists can attribute to task substitution within the Dutch eye care system.
English:
In recent years tasks reallocation between professions within Dutch eye care has been gaining importance in health policy, due to a higher demand for medical care and increasing financial costs. Empirical research focusing on the (potential) role of optometrists concerning task substitution barely exists, however. The aim of this study is to indicate the ‘substitution potential’ of optometrists within the eye care system. Based on patient-data of optometrists and general practitioners we estimated the substitution potential for a number of eye diseases. These diseases were judged as ‘substitutable’ according to two ophthalmologists and four optometrists. Results show that an annual shift of up to 207,000 general practitioner patients to the optometrist is possible, and up to 21,000 ophthalmologist patients can be prevented in case general practitioners refer patients with eye problems to the optometrist instead of the ophthalmologist. Our analysis estimated the potential pivotal volume taking by optometrists through task substitution within Dutch eye care. Results need to be interpreted carefully, however. A number of limitations have to be taken into account: (1) the list of potential substitutable’ eye diseases was assessed by only six experts, and (2) statistics on a limited number of eye diseases were available or comparable in datasets of general practice and optometrist practices. This study primarily provides a conceptual method to explore what volumes optometrists can attribute to task substitution within the Dutch eye care system.
Translated title of the contribution | Attention to the optometrist. A measurement of the substitution potential within Dutch eye care |
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Original language | Dutch |
Pages (from-to) | 497-504 |
Journal | Tijdschrift voor Gezondheidswetenschappen |
Volume | 91 |
Issue number | 8 |
Publication status | Published - Dec 2013 |
Externally published | Yes |