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Barriers between community screening for visual problems and treatments in a tertiary center
Ferreira, Gabriel de Almeida; Rezende, Marcelo Abrão; Meneghim, Roberta Lilian Fernandes de Sousa; Schellini, Silvana Artioli.
Affiliation
  • Ferreira, Gabriel de Almeida; Universidade Estadual Paulista. Faculdade de Medicina de Botucatu. Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço. São Paulo. BR
  • Rezende, Marcelo Abrão; Universidade Estadual Paulista. Faculdade de Medicina de Botucatu. Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço. São Paulo. BR
  • Meneghim, Roberta Lilian Fernandes de Sousa; Universidade Estadual Paulista. Faculdade de Medicina de Botucatu. Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço. São Paulo. BR
  • Schellini, Silvana Artioli; Universidade Estadual Paulista. Faculdade de Medicina de Botucatu. Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço. São Paulo. BR
Rev. saúde pública (Online) ; 52: 85, 2018. tab, graf
Article 在 En | LILACS | ID: biblio-979023
Responsible library: BR67.2
ABSTRACT
ABSTRACT 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 São 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.
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全文: 1 索引: LILACS 主要主题: Vision Disorders / Mass Screening / Tertiary Care Centers / Mobile Health Units 研究类型: Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies / Screening_studies 限制: Adolescent / Adult / Aged / Aged80 / Child / Child, preschool / Female / Humans / Infant / Male 国家/地区名称主题: America do sul / Brasil 语言: En 期刊: Rev. saúde pública (Online) 期刊主题: Sa£de P£blica 年: 2018 类型: Article

全文: 1 索引: LILACS 主要主题: Vision Disorders / Mass Screening / Tertiary Care Centers / Mobile Health Units 研究类型: Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies / Screening_studies 限制: Adolescent / Adult / Aged / Aged80 / Child / Child, preschool / Female / Humans / Infant / Male 国家/地区名称主题: America do sul / Brasil 语言: En 期刊: Rev. saúde pública (Online) 期刊主题: Sa£de P£blica 年: 2018 类型: Article