Department of Ophthalmology and Visual Sciences, Paulista Medical School, Federal University of Sao Paulo, Rua Botucatu, 816, São Paulo, SP, 04023-062, Brazil.
Department of Anthropology and Archaeology, University of Calgary, Calgary, AB, Canada.
Sci Rep. 2022 Aug 17;12(1):13941. doi: 10.1038/s41598-022-18054-6.
The current study aimed to investigate diabetic retinopathy (DR) screening and treatment coverages among diabetic patients evaluated through the Brazilian National Health Insurance from 2014 to 2019. The Brazilian Public Health System Information Database was used as the primary data source. DR screening coverage was calculated as the rate of procedures of clinical dilated fundus exam and color fundus photograph over the number of diabetic patients. DR treatment coverage was calculated as the rate of procedures of intravitreal injection, photocoagulation, and panretinal photocoagulation over the number of diabetic patients presumably in need of DR treatment. The overall screening coverage increased from 12.1% in 2014 to 21.2% in 2019 (p < 0.001) with substantial regional discrepancies so that North region was the only one with no changes along the period. The overall treatment coverage increased from 27.7% in 2014 to 44.1% in 2019, with Southeast and Midwest absorbing the demand for service from the North, Northeast and South. Despite an improvement along the past years, both screening and treatment coverages for DR in diabetes patients are ineffective in Brazil. Public health policies should address resources disparities throughout the country aiming to offer same healthcare conditions to patients regardless their geographic location.
本研究旨在调查 2014 年至 2019 年期间巴西国家医疗保险评估的糖尿病患者的糖尿病视网膜病变（DR）筛查和治疗覆盖率。巴西公共卫生系统信息数据库被用作主要数据源。DR 筛查覆盖率的计算方法是临床眼底扩张检查和眼底彩色照片程序的数量与糖尿病患者数量的比率。DR 治疗覆盖率的计算方法是玻璃体内注射、光凝和全视网膜光凝程序的数量与推测需要 DR 治疗的糖尿病患者数量的比率。总体筛查覆盖率从 2014 年的 12.1%增加到 2019 年的 21.2%（p<0.001），区域差异很大，只有北部地区在整个期间没有变化。总体治疗覆盖率从 2014 年的 27.7%增加到 2019 年的 44.1%，东南部和中西部吸收了来自北部、东北部和南部的服务需求。尽管近年来有所改善，但巴西糖尿病患者的 DR 筛查和治疗覆盖率仍不尽如人意。公共卫生政策应解决全国范围内的资源差异问题，旨在为患者提供相同的医疗保健条件，而不论其地理位置如何。
