ABSTRACT
PURPOSE: To evaluate the effectiveness of the tertiary care delivered to patients with vitreoretinal diseases in a defined urban population; to substantiate the planning and allocation of resources in order to improve the tertiary eye care delivery system in a specific area. METHODS: Data were collected from consecutive first-time patients between June 1, 2003 and July 31, 2004 in the Department of Ophthalmology, State University of Campinas, São Paulo, Brazil. Problem-solving capacity values were calculated for vitreoretinal surgery and photocoagulation. Data were entered into the Statistical Package for the Social Sciences (version 10.0). RESULTS: Of the 7500 patients referred to the Department, 641 were deemed suitable for analysis. The diagnoses analyzed were retinal detachment (26.0%), diabetic retinopathy (21.0%), and vitreous hemorrhage (7.7%). The median ages were 52, 59 and 57.5, respectively. Of all patients referred for retinal detachment, 26.5% were inoperable. The values obtained for the problem-solving capacity (PSC) showed that 38.1%, 33.0% and 93.5% of those eligible for an ophthalmic intervention (for retinal detachment, vitreous hemorrhage and diabetic retinopathy) had obtained treatment. The main reason for not giving treatment was the unavailability of operating room time and photocoagulation time (87.1%). CONCLUSIONS: This was the first study of tertiary eye care service performance in Latin America. Sight-threatening conditions such as retinal detachment and diabetic retinopathy are not thoroughly covered by the health system in this area. Various ways to reduce the problem are considered. The study has provided valuable information on planning high-complexity eye services in the population in question.
Subject(s)
Academic Medical Centers/statistics & numerical data , Delivery of Health Care/statistics & numerical data , Diabetic Retinopathy/surgery , Laser Coagulation/statistics & numerical data , Ophthalmology/statistics & numerical data , Retinal Detachment/surgery , Vitreous Hemorrhage/surgery , Brazil , Developing Countries , Female , Health Services Accessibility , Humans , Male , Middle Aged , Resource AllocationABSTRACT
PURPOSE: To determine the retention of knowledge along the years after certification of physicians as ophthalmology specialists. METHODS: The physicians, former ophthalmology residents, were selected at the Department of Ophthalmology, State University of Campinas, São Paulo, Brazil, and randomly allocated to three groups of seven individuals, according to the time as specialists. Group 1 consisted of one-year specialists, group 2 of five-year specialists and group 3 of ten-year specialists. Each participant answered a test with twenty-five multiple choice randomly selected questions, based on the national certificate tests applied by the Brazilian Ophthalmology Council between 1994 and 2003. Each question scored four points. RESULTS: The mean age of groups 1, 2 and 3 was 27, 30 and 36 years, respectively. A preponderance of males was found in all groups. Group 1 achieved the highest score, average of 88, group 2 achieved 77, and group 3 achieved the lowest, average of 64 (p<0.05). CONCLUSION: Loss of knowledge retention amongst specialists of the Brazilian Ophthalmology Council, has been observed along the years after the certification.
Subject(s)
Education, Medical, Continuing , Educational Measurement , Ophthalmology/education , Retention, Psychology , Specialty Boards , Adult , Brazil , Female , Humans , Male , Surveys and QuestionnairesABSTRACT
OBJETIVO: Determinar a retencão de conhecimento teórico ao longo dos anos, após a aprovacão para o título de especialista em oftalmologia. MÉTODOS: Foram selecionados aleatoriamente três grupos, com sete médicos cada, entre ex-residentes do Departamento de Oftalmologia da Universidade Estadual de Campinas. Os médicos do grupo 1 tinham sido aprovados para o título de especialista em oftalmologia do Conselho Brasileiro de Oftalmologia (CBO) há um ano, os do grupo 2 há cinco anos e os do grupo 3 há dez anos. Cada oftalmologista respondeu um teste escrito composto por 25 questões escolhidas aleatoriamente entre as provas aplicadas pelo CBO entre os anos 1994 e 2003. Cada questão valeu 4 pontos de um total de 100 possíveis. RESULTADOS: A média de idade dos grupos 1, 2 e 3 foi de 27, 30 e 36 anos, respectivamente. Preponderância do sexo masculino ocorreu em todos os grupos. A média de acertos do grupo 1 foi de 88 pontos, do grupo 2 foi de 77 pontos e do grupo 3 foi de 64 pontos (p<0,05). CONCLUSÕES: Houve diminuicão significativa da retencão de conhecimento teórico ao longo dos anos, após a aprovacão para o título de especialista em oftalmologia.
