Integration of refractive services provided by optometrists into the Portuguese National Health Service

Detalhes bibliográficos
Autor(a) principal: Carneiro, Vera L. Alves
Data de Publicação: 2023
Outros Autores: González-Méijome, José Manuel
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://hdl.handle.net/1822/87518
Resumo: Introduction: Refractive error is a public health concern and even with relatively simple and cost-effective interventions it remains usually outside national health services (NHSs) not ensuring universal health coverage. This study aimed to generate evidence about the availability and accessibility of refractive services in Portugal and to present a plan for more efficient services. Methods: A situation analysis of the Portuguese existing refractive services within the NHS was conducted based on three health systems building blocks: service delivery access, service coverage, and workforce. A strengths, weaknesses, opportunities, and threats analysis was performed based on existent evidence to identify internal and external factors that can facilitate or hinder the integration of refractive services within the NHS. The number of eye care personnel to be integrated in the NHS was calculated considering the minimum ratios recommended by national and international technical reports. Results: Portugal has no specific services to address refractive errors within the NHS. Treatment of refractive error occurs at the level of eye care general services. There are 39 NHS eye care services, all hospital-centred and divided into three large groups, according to technical differentiation, the technology required, and workforce capacity. The workforce available is composed of ophthalmologists and orthoptists, together with nurses and other general paramedical assistants. 3 Portuguese municipalities have more than 1 NHS eye care service, 35 have 1 NHS eye care service, and 240 municipalities (in the mainland) have none. In 2021, 52% of the hospitals providing eye care services did not meet the recommended response times. Centralization of eye care services in urban areas, undifferentiated referral systems, and a shortage in the workforce per inhabitant was observed. Conclusions: Portuguese NHS has all the requirements to reorientate refractive care from the current hospital-based model to primary care. The country also has a tr
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spelling Integration of refractive services provided by optometrists into the Portuguese National Health ServiceIntegração de serviços refrativos prestados por optometristas no serviço nacional de saúde portuguêsEye careNational health servicePortugalRefractive errorRefractive servicesErro refractivoServiços refractivosPortugalCuidados para a saúde da visãoServiço Nacional de SaúdeCiências Naturais::Ciências FísicasSaúde de qualidadeIntroduction: Refractive error is a public health concern and even with relatively simple and cost-effective interventions it remains usually outside national health services (NHSs) not ensuring universal health coverage. This study aimed to generate evidence about the availability and accessibility of refractive services in Portugal and to present a plan for more efficient services. Methods: A situation analysis of the Portuguese existing refractive services within the NHS was conducted based on three health systems building blocks: service delivery access, service coverage, and workforce. A strengths, weaknesses, opportunities, and threats analysis was performed based on existent evidence to identify internal and external factors that can facilitate or hinder the integration of refractive services within the NHS. The number of eye care personnel to be integrated in the NHS was calculated considering the minimum ratios recommended by national and international technical reports. Results: Portugal has no specific services to address refractive errors within the NHS. Treatment of refractive error occurs at the level of eye care general services. There are 39 NHS eye care services, all hospital-centred and divided into three large groups, according to technical differentiation, the technology required, and workforce capacity. The workforce available is composed of ophthalmologists and orthoptists, together with nurses and other general paramedical assistants. 3 Portuguese municipalities have more than 1 NHS eye care service, 35 have 1 NHS eye care service, and 240 municipalities (in the mainland) have none. In 2021, 52% of the hospitals providing eye care services did not meet the recommended response times. Centralization of eye care services in urban areas, undifferentiated referral systems, and a shortage in the workforce per inhabitant was observed. Conclusions: Portuguese NHS has all the requirements to reorientate refractive care from the current hospital-based model to primary care. The country also has a trIntrodução: O erro refrativo é um problema de saúde pública, mas mesmo com intervenções tecnicamente simples e com ótimo custo-benefício, permanece numa abordagem fora do serviço nacional de saúde (SNS) e sem garantias de cobertura universal. Este estudo pretendeu gerar evidência sobre a disponibilidade e acessibilidade de serviços refrativos em Portugal e apresentar um plano de ação para tornar estes serviços mais eficientes e equitativos. Métodos: Foi efetuada uma análise da situa ção e de prioridades aos serviços refrativos existentes no SNS português baseada em três blocos de construção dos sistemas de saúde: acesso, cobertura e força de trabalho. Uma análise SWOT baseada na evidência foi executada para identificar fatores internos e externos que pudessem facilitar ou comprometer a integração destes serviços. O número de profissionais a integrar foi calculado tendo em consideração os rácios mínimos recomendados. Resultados: Portugal não possui serviços específicos para o erro refrativo no SNS. A sua abordagem ocorre ao nível dos cuidados gerais de saúde da visão. Existem 39 serviços de cuidados de saúde da visão no SNS, todos centrados em meio hospitalar e que se di videm em três grandes grupos de acordo com a diferen ciação técnica, tecnologia existente e capacidade da força de trabalho. A força de trabalho é composta por médicos oftalmologistas e ortoptistas, juntamente com enfermeiros e outros assistentes paramédicos. 3 con celhos portugueses têm mais do que 1 serviço de cui dados de saúde da visão no SNS, 35 têm apenas 1 e 240 concelhos não possuem qualquer serviço público de cuidados de saúde da visão (todos em Portugal conti nental). Em 2021, 52% dos hospitais que prestam cui dados de saúde da visão não respeitavam os tempos recomendados. A centralização dos cuidados de saúde da visão em zonas urbanas e litorais, um sistema de refer enciação não diferenciado e escassez de força de trabalho são observados. Conclusão: O SNS português tem as condições necessárias para a reorientação dos cuidados refrativos do atual modelo hospitalar para os cuidados primários.This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.Karger PublishersUniversidade do MinhoCarneiro, Vera L. AlvesGonzález-Méijome, José Manuel20232023-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/1822/87518engCarneiro, V. L. A., & González-Méijome, J. M. (2023). Integration of Refractive Services Provided by Optometrists into the Portuguese National Health Service. Portuguese Journal of Public Health. S. Karger AG. http://doi.org/10.1159/0005300602504-31372504-314510.1159/000530060https://karger.com/pjp/article/41/2/111/862209/Integration-of-Refractive-Services-Provided-byinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-12-16T01:19:44Zoai:repositorium.sdum.uminho.pt:1822/87518Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T00:54:20.753387Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Integration of refractive services provided by optometrists into the Portuguese National Health Service
Integração de serviços refrativos prestados por optometristas no serviço nacional de saúde português
title Integration of refractive services provided by optometrists into the Portuguese National Health Service
spellingShingle Integration of refractive services provided by optometrists into the Portuguese National Health Service
Carneiro, Vera L. Alves
Eye care
National health service
Portugal
Refractive error
Refractive services
Erro refractivo
Serviços refractivos
Portugal
Cuidados para a saúde da visão
Serviço Nacional de Saúde
Ciências Naturais::Ciências Físicas
Saúde de qualidade
title_short Integration of refractive services provided by optometrists into the Portuguese National Health Service
title_full Integration of refractive services provided by optometrists into the Portuguese National Health Service
title_fullStr Integration of refractive services provided by optometrists into the Portuguese National Health Service
title_full_unstemmed Integration of refractive services provided by optometrists into the Portuguese National Health Service
title_sort Integration of refractive services provided by optometrists into the Portuguese National Health Service
author Carneiro, Vera L. Alves
author_facet Carneiro, Vera L. Alves
González-Méijome, José Manuel
author_role author
author2 González-Méijome, José Manuel
author2_role author
dc.contributor.none.fl_str_mv Universidade do Minho
dc.contributor.author.fl_str_mv Carneiro, Vera L. Alves
González-Méijome, José Manuel
dc.subject.por.fl_str_mv Eye care
National health service
Portugal
Refractive error
Refractive services
Erro refractivo
Serviços refractivos
Portugal
Cuidados para a saúde da visão
Serviço Nacional de Saúde
Ciências Naturais::Ciências Físicas
Saúde de qualidade
topic Eye care
National health service
Portugal
Refractive error
Refractive services
Erro refractivo
Serviços refractivos
Portugal
Cuidados para a saúde da visão
Serviço Nacional de Saúde
Ciências Naturais::Ciências Físicas
Saúde de qualidade
description Introduction: Refractive error is a public health concern and even with relatively simple and cost-effective interventions it remains usually outside national health services (NHSs) not ensuring universal health coverage. This study aimed to generate evidence about the availability and accessibility of refractive services in Portugal and to present a plan for more efficient services. Methods: A situation analysis of the Portuguese existing refractive services within the NHS was conducted based on three health systems building blocks: service delivery access, service coverage, and workforce. A strengths, weaknesses, opportunities, and threats analysis was performed based on existent evidence to identify internal and external factors that can facilitate or hinder the integration of refractive services within the NHS. The number of eye care personnel to be integrated in the NHS was calculated considering the minimum ratios recommended by national and international technical reports. Results: Portugal has no specific services to address refractive errors within the NHS. Treatment of refractive error occurs at the level of eye care general services. There are 39 NHS eye care services, all hospital-centred and divided into three large groups, according to technical differentiation, the technology required, and workforce capacity. The workforce available is composed of ophthalmologists and orthoptists, together with nurses and other general paramedical assistants. 3 Portuguese municipalities have more than 1 NHS eye care service, 35 have 1 NHS eye care service, and 240 municipalities (in the mainland) have none. In 2021, 52% of the hospitals providing eye care services did not meet the recommended response times. Centralization of eye care services in urban areas, undifferentiated referral systems, and a shortage in the workforce per inhabitant was observed. Conclusions: Portuguese NHS has all the requirements to reorientate refractive care from the current hospital-based model to primary care. The country also has a tr
publishDate 2023
dc.date.none.fl_str_mv 2023
2023-01-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://hdl.handle.net/1822/87518
url https://hdl.handle.net/1822/87518
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Carneiro, V. L. A., & González-Méijome, J. M. (2023). Integration of Refractive Services Provided by Optometrists into the Portuguese National Health Service. Portuguese Journal of Public Health. S. Karger AG. http://doi.org/10.1159/000530060
2504-3137
2504-3145
10.1159/000530060
https://karger.com/pjp/article/41/2/111/862209/Integration-of-Refractive-Services-Provided-by
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Karger Publishers
publisher.none.fl_str_mv Karger Publishers
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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