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Denise Fornazari Oliveira, Carlos E Arieta; Demand, capacity and flow of care in ophthalmology in the Campinas region, Brazil. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6108.
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This study aims to evaluate and characterize the ophthalmologic care within the Brazilian Health System (SUS) in the region of Campinas, and provide support for the network configuration of a regionalized health care in ophthalmology
We conducted a cross sectional study which included 62 cities from the State of São Paulo, that comprise the Regionalized Network for Health Care. Were evaluated service strategies, profiles of the professionals, integrated services of ophthalmologic care and also the thoughts of the health managers about the needs and requirements to achieve a quality care to the population. The Clinical Hospital of Unicamp is the reference for high complexity in this region. Only public health services and their partners were evaluated. The instrument was a semi-structured questionnaire, developed in the exploratory study and applied by direct interview.
The study area has a population of 4.805.691 inhabitants. There are services in ophthalmology in 77.4% of the municipalities. The entrance of patients into the system for eye care occurs mainly by primary care services and clinician referral. Waiting time for ophthalmology consultation is between 30 and 60 days. There is a waiting list for appointments in 58.0% of the municipalities totaling 27,159 patients. The total number of consultations available is approximately 21,512 a month. There are 115 ophthalmologists acting in the public service and there are 57 offices with basic ophthalmologic equipment. Patients of greater complexity are referred to appropriate services. There is no emergency assistance in ophthalmology, and 82.3% of the municipalities do not have operating room facilities for ophthalmology. There are waiting lists for cataract surgery in 80.6% of the municipalities. The majority of queues (81.8%) are concentrated in 8 cities and there are no data regarding queues for diseases of the retina. There is a system for reference and counter reference of patients in 53.2% of the municipalities and the majority does not have clinical protocols for ophthalmology.
The main difficulties found in the organization of care are related to flow of patients with more complex problems (referral, surgeries and procedures of retina). This study corroborates the necessity of organizing flow patient so that the available resources are better placed and investments can be made in order to attend the identified needs.
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