Barriers between community screening for visual problems and treatments in a tertiary center

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dc.contributor.authorFerreira, Gabriel de Almeida [UNESP]
dc.contributor.authorRezende, Marcelo Abrao [UNESP]
dc.contributor.authorFernandes de Sousa Meneghim, Roberta Lilian [UNESP]
dc.contributor.authorSchellini, Silvana Artioli [UNESP]
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.date.accessioned2019-10-04T12:33:25Z
dc.date.available2019-10-04T12:33:25Z
dc.date.issued2018-01-01
dc.description.abstractOBJECTIVE: 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.en
dc.description.affiliationUniv Estadual Paulista, Fac Med Botucatu, Dept Oftalmol Otorrinolaringol & Cirurgia Cabeca, Sao Paulo, SP, Brazil
dc.description.affiliationUnespUniv Estadual Paulista, Fac Med Botucatu, Dept Oftalmol Otorrinolaringol & Cirurgia Cabeca, Sao Paulo, SP, Brazil
dc.format.extent10
dc.identifierhttp://dx.doi.org/10.11606/S1518-8787.2018052000589
dc.identifier.citationRevista De Saude Publica. Sao Paulo: Revista De Saude Publica, v. 52, 10 p., 2018.
dc.identifier.doi10.11606/S1518-8787.2018052000589
dc.identifier.fileS0034-89102018000100283.pdf
dc.identifier.issn0034-8910
dc.identifier.scieloS0034-89102018000100283
dc.identifier.urihttp://hdl.handle.net/11449/185184
dc.identifier.wosWOS:000452457500001
dc.language.isoeng
dc.publisherRevista De Saude Publica
dc.relation.ispartofRevista De Saude Publica
dc.rights.accessRightsAcesso aberto
dc.sourceWeb of Science
dc.subjectBlindness, rehabilitation
dc.subjectEye Health Services
dc.subjectTriage
dc.subjectHealth Services Accessibility
dc.subjectTertiary Healthcare
dc.subjectOutcome and Process Assessment (Health Care)
dc.titleBarriers between community screening for visual problems and treatments in a tertiary centeren
dc.typeArtigo
dcterms.rightsHolderRevista De Saude Publica
unesp.author.orcid0000-0002-6938-1230[4]

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