Ophthalmology Department, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil.
Biostatistics Department, Instituto de Biociencias de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho, Botucatu, SP, Brazil.
Arq Bras Oftalmol. 2021 Nov-Dec;84(6):554-560. doi: 10.5935/0004-2749.20210092.
This study aimed to identify patient's reason for no-show at a university eye clinic after ophthalmic examination via a mobile ophthalmic unit, which provides comprehensive ophthalmic care to underserved communities in a region of Brazil.
In 2017/2018, this prospective observational study searched for no-shows at referrals to a university eye clinic after an outreach program screening via a mobile ophthalmic unit in 10 municipalities in the central-western region of São Paulo, Brazil. A total of 1,928 patients underwent a comprehensive eye examination at no cost, and 37.1% of them needed referral to a university eye clinic for specialized examinations or surgeries. We used the following two main tools: (1) comparative analysis between patients who attended the referral and those who did not; (2) active search using a questionnaire to assess reasons for no-show.
Attendance to referrals was not influenced by age, gender, distance from the university hospital, number of ophthalmologists in the municipality, average family income, and visual acuity. The main cause for referrals was cataract (350 cases). No-show was most common among glaucoma/suspected glaucoma (54.1%) cases, followed by strabismus (45%) and anterior segment disease (33.6%) cases. Many patients who did not attend the referral sought another service.
Patient's issues and lack of knowledge regarding their ophthalmic condition are the main reasons for no-show at referrals for free ophthalmic care. Thus, educational campaigns are needed to achieve consistently high attendance to prevent avoidable blindness.
本研究旨在通过移动眼科单位为巴西一个地区服务不足的社区提供全面的眼科护理，确定在眼科检查后，到大学眼科诊所就诊的患者未出现的原因。
在 2017/2018 年，这项前瞻性观察研究通过在巴西圣保罗中西部的 10 个城市的流动眼科单位对一项外展计划筛查进行转诊后，寻找大学眼科诊所的未出现患者。共有 1928 名患者接受了免费的全面眼科检查，其中 37.1%的患者需要转诊到大学眼科诊所进行专门的检查或手术。我们使用了以下两个主要工具：（1）比较参加转诊和未参加转诊的患者之间的差异；（2）使用问卷进行主动搜索，以评估未出现的原因。
转诊的出勤率不受年龄、性别、距离大学医院的远近、市立眼科医生的数量、家庭平均收入和视力的影响。转诊的主要原因是白内障（350 例）。未出现的情况最常见于青光眼/疑似青光眼（54.1%）病例，其次是斜视（45%）和前节疾病（33.6%）病例。许多未参加转诊的患者寻求了其他服务。
患者的问题以及对其眼部状况的了解不足是免费眼科护理转诊未出现的主要原因。因此，需要开展教育活动，以确保始终保持高出勤率，防止可避免的失明。
