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      Avaliação dos serviços de assistência ocular em população urbana de baixa renda da cidade de São Paulo - Brasil Translated title: Eye care services evaluation in a low-income urban population of São Paulo City - Brazil

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          Abstract

          OBJETIVO: Avaliar os serviços de assistência ocular do ponto de vista do usuário em população de baixa renda, na zona leste da cidade de São Paulo - Brasil. MÉTODOS: Estudo realizado por meio de inquérito domiciliar em uma amostra por conglomerados em três distritos de baixa renda da cidade de São Paulo - Brasil. No período de julho/2004 a janeiro/2005 foram realizadas 1.055 entrevistas com um representante do domicílio, sendo aplicado o questionário de responsividade aos serviços de assistência ocular em entrevista individual. RESULTADOS: Dos participantes, 71,56% eram mulheres. A idade dos respondentes variou de 18 a 92 anos (41,42 ± 15,67 anos). Quanto à escolaridade, 525 (49,77%) tinham 4 anos ou menos; 489 (46,35%) entre 5 e 11 anos; 40 (3,79%) 11 ou mais anos de estudo. Quanto à necessidade de utilização dos serviços de assistência ocular: 712 (67,49%) relataram que algum morador do seu domicílio necessitou e obteve assistência ocular e 135 (12,80%) nunca precisaram de assistência ocular. A barreira mais frequentemente citada para obtenção dos serviços de assistência ocular pelos respondentes foi o custo da consulta (77,29%) seguida de tentativa frustrada de obtenção da assistência ocular (42,21%). A frequência de avaliações positivas para os critérios contidos no questionário foi de 63,37%. Dos 36,63% respondentes insatisfeitos, o tempo de espera na sala de recepção dos serviços de assistência ocular foi o fator mais frequentemente apontado. CONCLUSÃO: As principais barreiras para obter assistência ocular foram o custo da consulta e a falta de acesso aos serviços, 63,37% dos indivíduos que necessitaram e obtiveram assistência ocular nos últimos 12 meses mostraram-se satisfeitos.

          Translated abstract

          PURPOSE: To evaluate eye care services from the user's perspective in a low income population from the east zone of the city of São Paulo - Brazil. METHODS: A household survey was performed using cluster sampling in three low income districts of the city of São Paulo - Brazil. From July/2004 to January/2005, 1055 interviews with an adult household representative were carried and an eye care system responsiveness questionnaire was administered through individual interview. RESULTS: 71.56% of the participants were women. Respondents' age ranged from 18 to 92 years (41.42 ± 15.67 years). Regarding schooling, 525 (49.77%) had four years or less; 489 (46.35%) between five and eleven years, 40 (3.79%) had eleven or more years of study. Eye care services need was reported as 712 (67.49%) declaring themselves or someone else of the household needing and obtaining services and 135 (12.80%) had never needed eye care. The most frequently cited barriers to obtain the eye care service by respondents was cost (77.29%), followed by unsuccessful attempt to obtain eye care (42.21%). General satisfaction for the criteria contained in the questionnaire was 63.37%. In the 36.63% dissatisfied respondents, the most frequently cited claim was the amount of time waited before consultation. CONCLUSION: The main barriers to obtain eye care services were cost of medical appointment and lack of access to the services. 63.37% of the individuals in need who had received eye care in last 12 months were satisfied with the service provided.

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          Patient satisfaction--an attribute or indicator of the quality of care?

          H Vuori (1987)
          Systematic measurement of patient satisfaction is seldom included in routine quality assurance (QA) programs. Practical reasons have been given to explain this omission: the mental and physical state of patients, their lack of the necessary scientific and technical knowledge, the rapid pace of events of care, and methodological problems related to measuring patient satisfaction. However, a strong case can be made to include patient satisfaction in QA, including ethical considerations, philosophical changes occurring in the health care field, and a clear definition of the impact of patient satisfaction on quality care. This article concludes that patient satisfaction is part and parcel of quality health care; that patients are capable of assessing the quality of care; and that patient satisfaction can be measured.
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            Measures of visual function and percentage of preferred walking speed in older adults: the Salisbury Eye Evaluation Project.

            The purpose of this study was to determine the association of static (visual acuity, visual fields, and contrast sensitivity) and dynamic (dynamic visual acuity and motion threshold) measures of vision with mobility performance on a mobility course with obstacles. A cross-sectional population-based study of 1504 persons aged 72 to 92 years enrolled in the third round of the Salisbury Eye Evaluation Project. Standardized examinations were used to test binocular visual acuity, better eye-contrast sensitivity, visual fields, dynamic visual acuity, and motion threshold. Cognitive status was assessed by using the standardized Mini-Mental State Examination. Participants were timed when walking a straight 4-m distance and when walking through a mobility course seeded with obstacles. The percentage of preferred walking speed (PPWS) for each subject was calculated as the ratio of mobility course speed to a 4-m walking speed expressed as a percentage. The mean age of the participants was 78.2 years. The mean 4-m walking speed was 0.82 m/s, whereas the mean mobility course speed was 0.47 m/s. The mean PPWS was 57.1%. All vision variables except visual acuity were associated with PPWS in univariate analyses. Multivariate models found visual fields and the cognitive state to be associated with PPWS. There was no association with dynamic measures of vision. The mobility performance, as measured by PPWS, was associated with visual fields but not with visual acuity, contrast sensitivity, or dynamic vision measures. Deficits in cognition also play an important role in predicting mobility performance.
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              Patient satisfaction with physician assistants (PAs) in an ED fast track.

              The study objective was to determine patient satisfaction with physician assistants (PAs) in an emergency department (ED) fast track (FT). An additional goal was to determine if patients would be willing to wait longer to be seen primarily by an emergency physician (EP) rather than a PA. The study was conducted between March 1, 1999 and May 1, 1999 at a community hospital with an annual ED census of 48,644 patients; 18% are seen in the ED FT. All patients were seen primarily by a PA. An anonymous survey was given to patients at time of discharge. Patients rated their degree of satisfaction by placing an X on a 100 millimeter visual analogue scale. Patients also indicated if they would be willing to wait longer to be seen primarily by an EP rather than a PA. A total of 111 surveys were analyzed, for a response rate of 11%. Sixty-two patients (56%) were women and 49 men (44%), with a mean age of 28 years. Twenty-seven patients (24%) were younger than 18 years and required a legal guardian to complete the survey. The mean patient satisfaction score was 93 (95% CI: 90.27 to 95.73). Only 13 patients (12%) indicated they would be willing to wait longer to be seen primarily by an EP rather than a PA. Patients seen in an ED FT are very satisfied with the care rendered by a PA. Few patients would be willing to wait longer in such a setting to be seen primarily by an EP.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                abo
                Arquivos Brasileiros de Oftalmologia
                Arq. Bras. Oftalmol.
                Conselho Brasileiro de Oftalmologia (São Paulo )
                1678-2925
                June 2009
                : 72
                : 3
                : 332-340
                Affiliations
                [1 ] Universidade Federal de São Paulo Brazil
                [2 ] Universidade Federal de São Paulo Brazil
                [3 ] Universidade Federal de São Paulo Brazil
                [4 ] Universidade Federal de São Paulo Brazil
                [5 ] Universidade Federal de São Paulo Brazil
                [6 ] Universidade Federal de São Paulo Brazil
                [7 ] Universidade Federal de São Paulo Brazil
                Article
                S0004-27492009000300010
                10.1590/S0004-27492009000300010
                55208dbe-2bd3-4086-9a86-e1711f3faa05

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0004-2749&lng=en
                Categories
                OPHTHALMOLOGY

                Ophthalmology & Optometry
                Patient satisfaction,Eye health services,Quality of health care,Quality assurance, health care,Eye diseases,Urban health services,Satisfação do paciente,Serviços de saúde ocular,Qualidade da assistência à saúde,Garantia da qualidade dos cuidados de saúde,Oftalmopatias,Serviços urbanos de saúde

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