Demand for Tertiary Eye Care Services in Developing Countries

Subburaman, Ganesh-Babu B; Hariharan, Luxme; Ravilla, Thulasiraj; Ravilla, Ravindran D; Kempen, John H.

doi:10.1016/j.ajo.2015.06.005

Cited by 17 publications

(8 citation statements)

References 4 publications

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“…Additional barriers might include negative attitudes towards services and difficult communication between providers and patients [10]. Studies in LMICs, have shown that the need for eye services is high and people often travel long distances to access these services [11]. Communities with inadequate or inaccessible eye care facilities tend to seek other alternatives of eye care services, including self-medication, which may further contribute to VI and blindness [12].…”

Section: Introductionmentioning

confidence: 99%

Utilization of Secondary Eye Care Services in Western Kenya

Rono

Macleod

Bastawrous

et al. 2019

IJERPH

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Background: Eye care provision is currently insufficient to meet the population’s eye health needs in Kenya. Many people remain unnecessarily visually impaired or at risk of becoming so due to treatable or preventable conditions. A lack of access and awareness of services are key barriers, in large part due to their being too few eye care providers in the health system for this unmet need. Methods: A hospital-based, retrospective analysis of patients who attended Kitale eye unit, Trans Nzoia County, Kenya from 1st January 2013 to 31st December 2015. Age and sex standardized hospital attendance rates by residence, age group, and sex were calculated for Trans Nzoia county and each subcounty. The changing trends in attendance rates were estimated by calculating the difference between base year and last year. Incidence rate ratios for attendance for each age-group, sex, and residence were estimated using a multivariable regression model. Results: 20,695 patients from the county were seen in Kitale Eye Unit in 2013, 2014 and 2015. In that period, 8.3% had either uncorrected refractive error, cataracts or glaucoma, the priority VISION2020 diseases, and 61.0% had allergic or other conjunctivitis or normal eyes, which could potentially be managed at primary eye care. During the study period, overall average annual attendance rate increased from 609 to 792 per 100, 000 population, incidence rate ratio (IRR) 1.30 (95% confidence interval (CI) 1.26–1.35). Attendance rates increased more in females than males (34.7% vs. 25.1%, respectively), IRR 1.07 (1.04–1.10). Attendance rates increased with increasing age, (highest among the elderly compared to the young). We found that in extreme age groups (>75 years and <15years) females were less likely to attend than males and there was reduced utilization from those based furthest from the hospital. Conclusion: Specialist eye services are heavily utilized by people with conditions that could be managed at the primary health care level. Barriers to accessing eye services were distance and gender, especially among the most vulnerable groups (young and the elderly). Integration of primary and secondary eye care services could lower barriers to essential eye care services to the population whilst lowering pressure on the limited specialist services by ensuring more appropriate utilization.

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Section: Introductionmentioning

confidence: 99%

Utilization of Secondary Eye Care Services in Western Kenya

Rono

Macleod

Bastawrous

et al. 2019

IJERPH

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“…In the modern era of gaining information via the internet, eye patients and their families seek subspecialist ophthalmologists for eye treatment. 11 , 12 This may also be the case for ocular emergencies arriving at a tertiary eye hospital. Prior research has shown the efficacy of ophthalmic triage.…”

Section: Discussionmentioning

confidence: 99%

Validity of an Ocular Emergency Triage System Compared to the Existing Grading System at the Emergency Unit of a Tertiary Eye Hospital in Saudi Arabia

Alsamnan¹,

Al-Amry²,

aldossari³

et al. 2023

OPTH

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Purpose To assess true ocular emergencies based on the ocular emergency triage system compared to the existing method of serving patients “first come first serve” by attending ophthalmology resident and review the validity of the triage system by ophthalmic subspecialty. Methods In this cross-sectional study of validity, new patients attending the ocular emergency department of a tertiary eye hospital in 2021–2022 were examined by ophthalmology resident. The time required for registration, an eye exam, and total time in the emergency unit was determined. Using ophthalmic triage criteria, same patients were reviewed by senior ophthalmologist to categorize them as “top emergencies”, “emergencies”, and “not an emergency.” The reviewer was masked about grading by an ophthalmology resident. The agreement rate for true emergencies by both methods of grading was calculated by subspecialty. Results One thousand patients with ocular emergencies were evaluated. The median overall time spent in the emergency unit was 92 minutes [interquartile range (IQR): 56; 142]. The revised triage system estimated 85% were “true emergencies.” Using both the revised triage and conventional methods, 172 (17.2%) patients were not considered as having an ocular emergency. The difference in patients grouped into “emergencies” (34.3% vs 21.4%) and “top emergencies” (46.5% vs 60.4%) was significant ( P <0.001) between methods. Uveitis (72%) had the lowest agreement between methods and pediatric ophthalmology (100%) had the highest agreement. Conclusion The revised ophthalmic triage system seems to be more efficient than existing method. Subspecialist ophthalmologists may provide quicker and better treatment if ophthalmic emergency patients are prioritized utilizing the proposed redesigned triage method.

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“…Thailand is one country with universal health coverage (UHC), which has covered all Thai citizens through 3 public health insurance schemes since 2002 (27). There is a high demand for public tertiary hospital services in developing countries (28). At the same time, there is a high prevalence of violence at tertiary hospitals (8,29).…”

Section: Introductionmentioning

confidence: 99%

Workplace Violence Against Healthcare Professionals in Thai Tertiary Hospitals

Kueanongkhun

Grisurapong

Techatraisak

et al. 2021

Preprint

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Background: Thailand lacks evidence of the current prevalence of workplace violence (WPV) at tertiary hospitals. This study aimed to examine the prevalence of, perpetrators of, and factors associated with WPV against healthcare workers in excellent tertiary hospitals in Thailand.Methods: This was a mixed-methods study. A questionnaire was individually administered by an interviewer to 220 healthcare workers using a tablet with an online platforms, and the completion rate was 100%. The study was conducted from July 2018 to March 2019. Pearson’s chi-square test was used to examine the variables related to any violence according to individual and work data. Odds ratios with 95% confidence intervals were used to assess risk factors for exposure to violence using a logistic regression model. Thirty participants provided additional qualitative data that were used for thematic analysis.Results: The findings revealed that in the past 12 months, 63.6% of the participants experienced violence at their workplaces. The most common type of violence reported was verbal violence (56.4%), followed by physical violence (24.1%), bullying (16.4%), sexual harassment (4.1%), and racial harassment (3.6%). Multivariable logistic regression revealed that the correlates of violence at hospitals included being male (OR = 4.28, 95% CI 1.50–12.19), working in an outpatient department (OR = 2.55, 95% CI 1.42–4.58), and having direct contact with clients (OR = 3.12, 95% CI 1.25–7.73). The qualitative data revealed 5 major themes.Conclusion: There is a high prevalence of violence against all healthcare workers at excellent tertiary hospitals in Thailand. Policymakers need to be aware of the roots and risk factors for all types of WPV. The results could also contribute to the development of appropriate policies, interventions for conflicts based on intergenerational gaps, reporting, investigation processes, preventive measures, and zero-tolerance protocols for all healthcare workers.

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Demand for Tertiary Eye Care Services in Developing Countries

Cited by 17 publications

References 4 publications

Utilization of Secondary Eye Care Services in Western Kenya

Utilization of Secondary Eye Care Services in Western Kenya

Validity of an Ocular Emergency Triage System Compared to the Existing Grading System at the Emergency Unit of a Tertiary Eye Hospital in Saudi Arabia

Workplace Violence Against Healthcare Professionals in Thai Tertiary Hospitals

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