ArticleBMJ open2017
Retrospective economic analysis of the transfer of services from hospitals to the community: an application to an enhanced eye care service.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed.
- Tele-ophthalmology-enabled and artificial intelligence-ready referral pathway for community optometry referrals of retinal disease: HERMES cluster randomised trial with a diagnostic accuracy study.Health technology assessment (Winchester, England) · 2025Trial
- Improving Access and Reducing the Burden on Public Ophthalmology: Collaborative Telehealth Models Between Ophthalmology and Optometry in Australia.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2026Article
- The safety and effectiveness of optometrist delivered laser peripheral iridotomy.Eye (London, England) · 2026Article
- A review of UK primary care pathways for acute ophthalmic conditions.Eye (London, England) · 2025Review
- Hospital to community in Wales: What is the value of optometrists playing a greater role in managing neovascular AMD and glaucoma in primary care?Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2025Article
- Enhancing Ophthalmic Triage: identification of new clinical features to support healthcare professionals in triage.Eye (London, England) · 2024Article
- The burden of acute eye conditions on different healthcare providers: a retrospective population-based study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- The effectiveness of interventions for optometric referrals into the hospital eye service: A review.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2023Review
- A prospective evaluation of the clinical safety and effectiveness of a COVID-19 Urgent Eyecare Service across five areas in England.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2022Article
- Optometrist referrals to an emergency ophthalmology department: a retrospective review to identify current practise and development of shared care working strategies, in England.Eye (London, England) · 2021Article
- A needs assessment for a minor eye condition service within Leeds, Bradford and Airedale, UK.BMC health services research · 2019Article
- Clinical safety of a minor eye conditions scheme in England delivered by community optometrists.BMJ open ophthalmology · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis research aims to evaluate the wider health system effects of the introduction of an intermediate-tier service for eye care.
settingThis research employs the Minor Eye Conditions Scheme (MECS), an intermediate-tier eye care service introduced in two London boroughs, Lewisham and Lambeth, in April 2013.
designRetrospective difference-in-differences analysis comparing changes over time in service use and costs between April 2011 and October 2014 in two commissioning areas that introduced an intermediate-tier service programme with changes in a neighbouring area that did not introduce the programme. DATA SOURCES: MECS audit data; unit costs for MECS visits; volumes of first and follow-up outpatient attendances to hospital ophthalmology; the national schedule of reference costs.
main outcome measuresVolumes and costs of patients treated.
resultsIn one intervention area (Lewisham), general practitioner (GP) referrals to hospital ophthalmology decreased differentially by 75.2% (95% CI -0.918% to -0.587%) for first attendances, and by 40.3% for follow-ups (95% CI -0.489% to -0.316%). GP referrals to hospital ophthalmology decreased differentially by 30.2% (95% CI -0.468% to -0.137%) for first attendances in the other intervention area (Lambeth). Costs increased by 3.1% in the comparison area between 2011/2012 and 2013/2014. Over the same period, costs increased by less (2.5%) in one intervention area and fell by 13.8% in the other intervention area.
conclusionsIntermediate-tier services based in the community could potentially reduce volumes of patients referred to hospitals by GPs and provide replacement services at lower unit costs.
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