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[公立和私立医疗系统中接受白内障手术患者获得治疗的困难]

[Difficulties in access to treatment for patients undergoing cataract surgery in public and private health systems].

作者信息

Kara-Júnior Newton, Dellapi Roberto, Espíndola Rodrigo França de

机构信息

Ophthalmology Department, Faculdade de Medicina, Universidade de São Paulo, Brazil.

出版信息

Arq Bras Oftalmol. 2011 Sep-Oct;74(5):323-5. doi: 10.1590/s0004-27492011000500002.

Abstract

PURPOSE

To identify the difficulties in access to diagnosis and treatment of cataract in patients attended during a cataract campaign.

METHODS

A questionnaire was administered to patients selected for cataract surgery. We evaluated, among others, the following variables: prior access to ophthalmologists (public or private), reason(s) for not having surgery early in the initial service, the average cost charged by cataract surgery and intraocular lens (IOL) (private services and agreements).

RESULTS

A total of 627 patients was evaluated. Most of them - 595 (95%) had previously attended an ophthalmologist, and in 63% of cases (375 patients) the consultation had been held for less than a year. The last evaluation was performed by the Brazilian Public Health System (SUS) in 52% of the cases (307 patients). Regarding the reason for not having surgery in the initial service, the high cost of the surgery (R$ 2.000 - R$ 4.000) and the cost of IOLs (R$ 1.000 - R$ 1.500) was the main obstacle for most attended services and private covenants.

CONCLUSION

The results of this study suggest that the routine of ophthalmologic care in SUS at São Paulo is not prepared to answer the demand for cataract surgeries and private healthcare system still excludes a portion of the population. It is important to continue the implementation of community campaigns to serve the population that would be unable to access the surgery through conventional ways.

摘要

目的

确定在白内障防治活动中接受治疗的患者在获得白内障诊断和治疗方面存在的困难。

方法

对选定进行白内障手术的患者进行问卷调查。我们评估了以下变量:此前看眼科医生的情况(公立或私立)、在初次就诊时未及早进行手术的原因、白内障手术和人工晶状体(IOL)的平均收费(私立服务和协议)。

结果

共评估了627名患者。其中大多数——595名(95%)此前看过眼科医生,63%的病例(375名患者)就诊时间不到一年。52%的病例(307名患者)的最后一次评估由巴西公共卫生系统(SUS)进行。关于在初次就诊时未进行手术的原因,手术的高费用(2000雷亚尔至4000雷亚尔)和人工晶状体的费用(1000雷亚尔至1500雷亚尔)是大多数就诊服务机构和私立医疗机构的主要障碍。

结论

本研究结果表明,圣保罗州SUS的眼科护理常规无法满足白内障手术需求,私立医疗系统仍然排斥一部分人群。继续开展社区防治活动以服务那些无法通过传统方式获得手术治疗的人群非常重要。

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