Barriers between community screening for visual problems and treatments in a tertiary center
| Autor: | Silvana Artioli Schellini, Roberta Lilian Fernandes de Sousa Meneghim, Marcelo Abrão Rezende, Gabriel de Almeida Ferreira |
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| Přispěvatelé: | Universidade Estadual Paulista (Unesp) |
| Rok vydání: | 2018 |
| Předmět: |
Male
Pediatrics Visual acuity Visual Acuity Eye Health Services Community screening Pterygium Health Services Accessibility Tertiary Care Centers 0302 clinical medicine Prevalence Mass Screening Medicine Prospective Studies 030212 general & internal medicine Child Prospective cohort study Aged 80 and over Blindness rehabilitation lcsh:Public aspects of medicine Middle Aged Treatment Outcome Child Preschool Female Original Article medicine.symptom Brazil After treatment Adult medicine.medical_specialty Adolescent Referral Visual impairment Vision Disorders Cataract Statistics Nonparametric Young Adult 03 medical and health sciences Cataracts Humans Cities Aged Tertiary Healthcare business.industry Public Health Environmental and Occupational Health Infant lcsh:RA1-1270 Mean age Outcome and Process Assessment (Health Care) medicine.disease 030221 ophthalmology & optometry Triage business Mobile Health Units |
| Zdroj: | Revista de Saúde Pública v.52 2018 Revista de Saúde Pública Universidade de São Paulo (USP) instacron:USP Web of Science Repositório Institucional da UNESP Universidade Estadual Paulista (UNESP) instacron:UNESP Revista de Saúde Pública, Volume: 52, Article number: 85, Published: 29 NOV 2018 Revista de Saúde Pública, Vol 52, Iss 0 (2018) |
| ISSN: | 1518-8787 0034-8910 |
| DOI: | 10.11606/s1518-8787.2018052000589 |
| Popis: | Made available in DSpace on 2019-10-04T12:33:25Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-01-01. Added 1 bitstream(s) on 2019-10-09T18:33:46Z : No. of bitstreams: 1 S0034-89102018000100283.pdf: 246697 bytes, checksum: 3a6c3abd6d1483dfb0ea487b500c92ce (MD5) OBJECTIVE: To evaluate the effectiveness of mobile ophthalmic unit screenings and to investigate barriers between community care and resolution of the problem at a tertiary center. METHODS: This prospective study evaluated a convenience sample from 10 municipalities in Sao Paulo State, Brazil. Patients were assessed in the municipality by a mobile ophthalmic unit and underwent a complete ophthalmic consultation. Patients were referred as warranted to a tertiary hospital. RESULTS: The mobile ophthalmic unit screened 1,928 individuals and 714 (37%) were referred. The mean age of the referred patients was 57.12 (SD = 19.5) years with best corrected visual acuity of 0.37 (SD = 0.36) logMAR. Forty-seven (6.6%) patients were blind and 185 (26.5%) were visually impaired. Cataracts (44.7%) and pterygium (14.7%) accounted for most referrals. Of those referred, 67.1% presented to the tertiary center. The diagnosis by the mobile ophthalmic unit corresponded to the one by the tertiary center in 88.5% of the cases. There were a significantly higher number of blind and visually impaired persons among those who presented to the hospital. There was a significantly greater attendance among patients living in more distant municipalities from the reference center with a higher number of inhabitants and a greater number of ophthalmologists in the cities of origin (p < 0.05, all comparisons). Complete treatment was performed in 65.6% of patients, and loss to follow-up was the main cause of incomplete treatment in 50.7% of patients. A total of 313 cataract surgeries were performed, which reduced the number of blind patients from 20 to 2 and of visually impaired individuals from 87 to 2 (p < 0.001). CONCLUSIONS: Only 37% of the patients assessed by a mobile ophthalmic unit required referral to a tertiary hospital. Among the referred patients, 67.1% presented to the hospital, and complete resolution after treatment was approximately 65.5%. There was a significant improvement in visual acuity and a reduction in the prevalence of blindness and visual impairment postoperatively. Univ Estadual Paulista, Fac Med Botucatu, Dept Oftalmol Otorrinolaringol & Cirurgia Cabeca, Sao Paulo, SP, Brazil Univ Estadual Paulista, Fac Med Botucatu, Dept Oftalmol Otorrinolaringol & Cirurgia Cabeca, Sao Paulo, SP, Brazil |
| Databáze: | OpenAIRE |
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