Clinical and regulatory protocols for the management of impaired vision in the public health care network

Arquivos Brasileiros de Oftalmologia

Jayter Silva Paula²  João Marcello Fortes Furtado²  Fabiano Cade Jorge²  Eduardo Melani Rocha²  Ingrid U. Scott¹  Luciane Loures Dos Santos¹  Maria De Lourdes Veronese Rodrigues²  José Sebastião Dos Santos¹ 

[1] ,Universidade de São Paulo Ribeirão Preto School of Medicine Department of Ophthalmology, Otorhinolaryngology and Head and Neck SurgeryRibeirão Preto SP ,Brazil

关键词: Vision disorders;    Delivery of health care;    Public Health;    Health Services;    Primary health care;    Health systems;    Clinical protocols;    Transtornos da visão;    Assistência à saúde;    Saúde Pública;    Serviços de Saúde;    Atenção primária à saúde;    Sistema de saúde;    Protocolos clínicos;   

DOI  :  10.1590/S0004-27492011000300006

来源: SciELO

【 摘 要 】

PURPOSE: To describe the procedures used in developing Clinical and Regulatory Protocols for primary care teams to use in the management of the most common scenarios of impaired vision in Southern Brazil. METHODS: A retrospective review of 1.333 referral forms from all primary care practitioners was performed in Ribeirão Preto city, during a 30-day period. The major ophthalmic diagnostic categories were evaluated from those referrals forms. The Clinical and Regulatory Protocols development process was held afterwards and involved scientific cooperation between a university and the health care system, in the form of workshops attended by primary care practitioners and regulatory system team members composed of health care administrators, ophthalmologists, and professors of ophthalmology and social medicine. RESULTS: The management of impaired vision was chosen as the theme, since it accounted for 43.6% of the ophthalmology-related referrals from primary care providers of Ribeirão Preto. The Clinical and Regulatory Protocols developed involve distinctive diagnostic and therapeutic interventions that can be performed at the primary care level and in different health care settings. The most relevant clinical and regulatory interventions were expressed as algorithms in order to facilitate the use of the Clinical and Regulatory Protocols by health care practitioners. CONCLUSIONS: These Clinical and Regulatory Protocols could represent a useful tool for health systems with universal access, as well as for health care networks based on primary care and for regulatory system teams. Implementation of these Clinical and Regulatory Protocols can minimize the disparity between the needs of patients with impaired vision and the treatment modalities offered, resulting in a more cooperative health care network.

【 授权许可】

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