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基层医疗保健中视力丧失患者的筛查:一项针对匈牙利贫困人群的横断面研究。

Screening for Patients with Visual Acuity Loss in Primary Health Care: A Cross Sectional Study in a Deprived Hungarian Population.

作者信息

Wasnik Rahul Naresh, Győri-Dani Veronika, Vincze Ferenc, Papp Magor, Pálinkás Anita, Sándor János

机构信息

Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary.

Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary.

出版信息

Healthcare (Basel). 2023 Jul 5;11(13):1941. doi: 10.3390/healthcare11131941.

Abstract

Screening for visual acuity loss (VAL) is not applied systematically because of uncertain recommendations based on observations from affordable countries. Our study aimed to evaluate the effectiveness of primary health care-based screening. A cross-sectional investigation was carried out among adults who did not wear glasses and did not visit an ophthalmologist in a year (N = 2070). The risk factor role of sociodemographic factors and the cardiometabolic status for hidden VAL was determined by multivariable linear regression models. The prevalence of unknown VAL of at least 0.5 was 3.7% and 9.1% in adults and in the above-65 population. Female sex (b = 1.27, 95% CI: 0.35; 2.18), age (b = 0.15, 0.12; 0.19), and Roma ethnicity (b = 2.60, 95% CI: 1.22; 3.97) were significant risk factors. Higher than primary school (b = -2.06, 95% CI: -3.64; -0.47; and b = -2.08, 95% CI: -3.65; -0.51), employment (b = -1.33, 95% CI: -2.25; 0.40), and properly treated diabetes mellitus (b = -2.84, 95% CI: -5.08; -0.60) were protective factors. Above 65 years, female sex (b = 3.85, 95% CI: 0.50; 7.20), age (b = 0.39, 95% CI: 0.10; 0.67), Roma ethnicity (b = 24.79, 95% CI: 13.83; 35.76), and untreated diabetes (b = 7.30, 95% CI: 1.29; 13.31) were associated with VAL. Considering the huge differences between the health care and the population's social status of the recommendation-establishing countries and Hungary which represent non-high-income countries, the uncertain recommendation of VAL screening should not discourage general practitioners from organizing population-based screening for VAL in non-affordable populations.

摘要

由于基于来自可负担得起国家的观察结果所给出的建议并不明确,视力丧失筛查(VAL)尚未得到系统应用。我们的研究旨在评估基于初级卫生保健的筛查的有效性。对一年内未戴眼镜且未看过眼科医生的成年人(N = 2070)进行了一项横断面调查。通过多变量线性回归模型确定社会人口学因素和心脏代谢状况对隐匿性VAL的危险因素作用。在成年人和65岁以上人群中,至少0.5的未知VAL患病率分别为3.7%和9.1%。女性(b = 1.27,95%置信区间:0.35;2.18)、年龄(b = 0.15,0.12;0.19)和罗姆族裔(b = 2.60,95%置信区间:1.22;3.97)是显著的危险因素。高于小学学历(b = -2.06,95%置信区间:-3.64;-0.47;以及b = -2.08,95%置信区间:-3.65;-0.51)、就业(b = -1.33,95%置信区间:-2.25;0.40)和糖尿病得到妥善治疗(b = -2.84,95%置信区间:-5.08;-0.60)是保护因素。在65岁以上人群中,女性(b = 3.85,95%置信区间:0.50;7.20)、年龄(b = 0.39,95%置信区间:0.10;0.67)、罗姆族裔(b = 24.79,95%置信区间:13.83;35.76)和未治疗的糖尿病(b = 7.30,95%置信区间:1.29;13.31)与VAL相关。考虑到建议制定国家与代表非高收入国家的匈牙利在医疗保健和人口社会地位方面存在巨大差异,VAL筛查建议的不确定性不应阻碍全科医生在无法负担筛查费用的人群中组织基于人群的VAL筛查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4be6/10341402/b183a3a6f6e5/healthcare-11-01941-g001.jpg

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