JAMA ophthalmology · 2026
Resident to Urgent Eye Clinic Transformation and Association With Health Equity and Resident Education.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ojo Sharon, Dogra Neil, Wallace Laura, DiLoreto David A, Wozniak Rachel A F, Hu Wen Fan
Аннотация
IMPORTANCE: US ophthalmology residency programs are divided between traditional resident clinic-based models with a separate faculty practice, and universal practice-based models. Little data exist comparing these educational models.
OBJECTIVE: To evaluate the association of changing a traditional resident clinic training model to a universal practice plus urgent eye clinic-based residency training model with sociodemographic disparities and resident education.
DESIGN, SETTING, AND PARTICIPANTS: This was a cross-sectional study conducted at a US academic medical center. All patients presenting to the University of Rochester Flaum Eye Institute between the period July 1, 2017, to June 30, 2019, and the period July 1, 2022, to June 30, 2024, were divided into 4 cohorts for retrospective analysis as follows: resident clinic 2017-2019, faculty practice 2017-2019, urgent eye clinic 2022-2024, and universal practice 2022-2024.
EXPOSURES: The resident clinic was transitioned to urgent eye clinic in July 2022. All former patients from resident clinic were reassigned to the new universal practice.
MAIN OUTCOMES AND MEASURES: Patient cohorts were compared regarding insurance payor(s) and self-identified race. Level of disease acuity in resident clinic and urgent eye clinic were compared. Graduating resident procedural volumes were compared.
RESULTS: Participants were divided into the following 4 cohorts: resident clinic 2017-2019 (6819 patients), faculty practice 2017-2019 (61 847 patients), urgent eye clinic 2022-2024 (5124 patients), and universal practice 2022-2024 (79 001 patients), for a total of 118 459 patients (mean [SD] age, 47 [25] years; 65 186 female [55%]). Pretransition, compared with faculty practice patients, greater proportions of resident clinic patients used Medicaid insurance (62.1% vs 19.4%; difference, 32.0%; 95% CI, 30.9%-33.1%; P < .001) and identified as Asian, Black or African American, multiracial, native (ie, American Indian or Alaska Native), or other (51.9% vs 23.6%; difference, 28.3%; 95% CI, 27.1%-29.5%; P < .001). Posttransition, compared with universal practice patients, similar proportions of urgent eye clinic patients used Medicaid insurance (26.8% vs 27.8%; difference, 0.4%; 95% CI, -0.7% to 1.6%; P = .42) and identified as Asian, Black or African American, multiracial, native, or other (29.6% vs 26.8%; difference, 2.8%; 95% CI, 1.5%-4.1%; P < .001). A greater proportion of urgent eye clinic patients presented with high-acuity disease (37.6%) compared with resident clinic patients (20.9%; difference, 16.7%; 95% CI, 15.0%-18.4%; P < .001). Median graduating resident primary cataract surgery volume increased from 148 to 228 cases (difference, 80; 95% CI, 49 to 122; P < .001).
CONCLUSIONS AND RELEVANCE: Results of this cross-sectionals study show that transforming resident clinic into urgent eye clinic was associated with reduced sociodemographic disparities, enhanced resident exposure to high-acuity disease, and increased resident procedural experience. These results suggest that changes in resident clinic structure may improve both health equity and resident education.
OBJECTIVE: To evaluate the association of changing a traditional resident clinic training model to a universal practice plus urgent eye clinic-based residency training model with sociodemographic disparities and resident education.
DESIGN, SETTING, AND PARTICIPANTS: This was a cross-sectional study conducted at a US academic medical center. All patients presenting to the University of Rochester Flaum Eye Institute between the period July 1, 2017, to June 30, 2019, and the period July 1, 2022, to June 30, 2024, were divided into 4 cohorts for retrospective analysis as follows: resident clinic 2017-2019, faculty practice 2017-2019, urgent eye clinic 2022-2024, and universal practice 2022-2024.
EXPOSURES: The resident clinic was transitioned to urgent eye clinic in July 2022. All former patients from resident clinic were reassigned to the new universal practice.
MAIN OUTCOMES AND MEASURES: Patient cohorts were compared regarding insurance payor(s) and self-identified race. Level of disease acuity in resident clinic and urgent eye clinic were compared. Graduating resident procedural volumes were compared.
RESULTS: Participants were divided into the following 4 cohorts: resident clinic 2017-2019 (6819 patients), faculty practice 2017-2019 (61 847 patients), urgent eye clinic 2022-2024 (5124 patients), and universal practice 2022-2024 (79 001 patients), for a total of 118 459 patients (mean [SD] age, 47 [25] years; 65 186 female [55%]). Pretransition, compared with faculty practice patients, greater proportions of resident clinic patients used Medicaid insurance (62.1% vs 19.4%; difference, 32.0%; 95% CI, 30.9%-33.1%; P < .001) and identified as Asian, Black or African American, multiracial, native (ie, American Indian or Alaska Native), or other (51.9% vs 23.6%; difference, 28.3%; 95% CI, 27.1%-29.5%; P < .001). Posttransition, compared with universal practice patients, similar proportions of urgent eye clinic patients used Medicaid insurance (26.8% vs 27.8%; difference, 0.4%; 95% CI, -0.7% to 1.6%; P = .42) and identified as Asian, Black or African American, multiracial, native, or other (29.6% vs 26.8%; difference, 2.8%; 95% CI, 1.5%-4.1%; P < .001). A greater proportion of urgent eye clinic patients presented with high-acuity disease (37.6%) compared with resident clinic patients (20.9%; difference, 16.7%; 95% CI, 15.0%-18.4%; P < .001). Median graduating resident primary cataract surgery volume increased from 148 to 228 cases (difference, 80; 95% CI, 49 to 122; P < .001).
CONCLUSIONS AND RELEVANCE: Results of this cross-sectionals study show that transforming resident clinic into urgent eye clinic was associated with reduced sociodemographic disparities, enhanced resident exposure to high-acuity disease, and increased resident procedural experience. These results suggest that changes in resident clinic structure may improve both health equity and resident education.