[Outcomes and health services research in ophthalmology]

[Subjective and objective work stress among ophthalmologists in private practice in Thuringia : Results of a state-wide survey]

BACKGROUND

Physicians are highly vulnerable to work-related stress; however, little is known about the workload of ophthalmologists.

MATERIAL AND METHODS

In March 2017 a cross-sectional and paper-based survey of all practice-based ophthalmologists in the federal state of Thuringia was conducted. Additionally, data from 2016 and 2009 using physician fee schedule datasets provided by the Thuringian Association of Statutory Health Insurance Physicians were analyzed.

RESULTS

The response rate was 27% (n = 42 ophthalmologists) of which 95% (n = 40) exceeded the effort-reward cut-off value (>1) indicating a high level of work stress. The overall number of treatment cases did not show a statistically significant difference between 2016 and 2009 (n = 118 ophthalmologists, p = 0.412). In contrast, the number of treatment cases of patients with type 2 diabetes mellitus and essential (primary) hypertension was statistically significantly higher in 2016 compared to 2009 (n = 118 ophthalmologists, p < 0.05).

CONCLUSION

Almost all respondents reported a high level of work stress and this was reflected in the number of treatment cases of patients with type 2 diabetes mellitus and essential hypertension, which was statistically significantly higher in 2016 than in 2009. The results suggest that working conditions should be adapted to meet the needs of chronically ill patients and reduce physicians' workload at the same time.

[Use of hospital data for ophthalmological research : A feasibility study]

AIMS

This study was carried out to investigate whether ophthalmology hospitals can exchange patient data for research purposes, i.e. whether this is technically and legally feasible and whether it is worthwhile, i.e. whether the data are useful for answering important medical questions.

METHODS

In-depth interviews were conducted with experts and a literature search was carried out.

RESULTS

Patient data were found to be fundamentally well-suited for research purposes and there is a corresponding need for research. There are also specific scientific question which need to be answered, e.g. development of visual acuity after various surgical procedures for glaucoma. There are also legal and technical difficulties but it is possible to solve these problems. Potential solutions are described.

DISCUSSION

The results of this study show that it is basically feasible for hospitals and hospital personnel to exchange patient data and to combine them. As opposed to earlier attempts which tried to collect as much data as possible and then analyzed what to do with the data afterwards, it is recommended that a medical question should first be defined followed by a search for data afterwards. Furthermore, researching would be facilitated by an improved exchange of data by information systems.