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Advisor(s)
Abstract(s)
Apesar dos recursos existentes em Portugal e da disponibilidade dos mesmos, os cuidados
fornecidos pelo Serviço Nacional de Saúde (SNS) em Oftalmologia, que se caracterizam por
grandes listas de espera e um exagerado tempo de resposta, seja no acesso a uma primeira
consulta de oftalmologia seja no acesso aos cuidados cirúrgicos oftalmológicos, representam
um dos problemas mais perseverantes, críticos e difíceis de solucionar. Isto porque os cuidados
primários de saúde da visão ainda não abrangem a inclusão dos Optometristas Portugueses, uma
vez que não é uma prática empregue pelo SNS. No que diz respeito à implementação e
desenvolvimento das reformas desejadas para os cuidados primários de saúde da visão, os
optometristas têm um papel basilar, dado que o sistema visual representa algo essencial no que
diz respeito aos nossos sentidos. Ao longo da vida podem existir alterações visuais que devem
ser prematuramente detetadas e tratadas. Os resultados e o impacto destas alterações nos
indivíduos e na sociedade alertam-nos para o grande problema do SNS não proporcionar
atempadamente os cuidados primários de saúde da visão que, em tempo útil, poderiam prevenir
as suas consequências.
Objetivo: Esta investigação tem como objetivo analisar o impacto da inserção dos
Optometristas nos cuidados de saúde primários em Portugal e averiguar se a inserção destes
profissionais traria eficácia na prestação de cuidados de saúde da visão.
Métodos: A inserção dos profissionais de Optometria no SNS tem sido muito discutida nos
últimos tempos. Porém, não há estudos em Portugal que demonstrem a eficácia da inserção
dos optometristas no SNS. O presente trabalho teve por base um estudo levado a cabo em três
países europeus: Reino Unido, Alemanha e França, sobre a prestação de cuidados primários de
saúde da visão “Comparative Analysis of Delivery of Primary Eye Care in Three European
Countries” (Thomas, et al., 2011) e, a partir da estrutura básica da prestação de serviços de
optometria nesses países, analisar como é que estão organizados esses cuidados primários de
saúde da visão em Portugal.
Resultados: Com base na recolha de dados obtidos de fontes eletrónicas, como por exemplo, o
número de médicos oftalmologistas no SNS, a evolução do total de consultas hospitalares em
Oftalmologia, a evolução dos pedidos pendentes por prioridade na triagem, entre outros,
constata-se que o número de médicos Oftalmologistas inseridos no SNS é escasso para atender
todos os pedidos pendentes existentes e que os profissionais de Optometria podem
desempenhar um papel ativo na resolução do problema de inexistência de prestação de
cuidados primários de saúde da visão no SNS.
Com base nos dados recolhidos e nas sugestões das Autoridades Internacionais de Saúde para a
especialidade de oftalmologia, constata-se que existe uma escassez de 113 médicos
oftalmologistas no SNS, para um horário de trabalho de 40h/semana. Constata-se igualmente
que a área de Oftalmologia é a segunda especialidade com maior peso nas consulta representando cerca de 8,3% do total, e que, para aceder à mesma, o tempo médio de resposta
até à sua realização é de 180,2 dias (6 meses), para dados de 2017. Daqui infere-se a enorme
insuficiência de recursos alocados à prestação de cuidados de saúde da visão e o papel central
que os optometristas poderão desempenhar, através dos cuidados primários, na resolução deste
problema.
Conclusão: Apesar de não conseguirmos valores concretos, quantificáveis e discriminados sobre
a eficácia da inserção dos Optometristas no SNS, com os valores apresentados nesta dissertação
e com as justificações em relação aos parâmetros evidenciados, consideramos que o acesso aos
cuidados primários de saúde da visão seria facilitado com o reconhecimento destes profissionais
pelo SNS. Neste sentido, tornar-se-ia necessário que o âmbito da actividade diferenciada de
cada profissional na área da saúde visual fosse legalmente instituída e regulamentada no quadro
do SNS para que se conseguisse dar resposta ao máximo de utentes possíveis nesta área de
saúde e, assim, resolver o máximo de pedidos pendentes, atenuar as listas de espera e melhorar
a qualidade de vida das pessoas.
Although the medical resources in Portugal are easily available for everyone, ophthalmology services are often linked to huge waiting lists and disproportional response time, both in access to the first ophthalmology appointment or access to surgical care. This situation stands as one of the most critical, perseverant and hard problem to solve. The main reason for this situation is the fact that Portuguese eye care services do not include Optometrists, since they are not part of SNS. Regarding the implementation and development of primary eye care reforms, optometrists will play a key role, since the visual system is essential for our daily life. Throughout life, changes in our visual system must be prematurely detected and treated. The results and impact of these changes in the individual and in the society, warns us that is a big mistake not providing suitable primary care, that could prevent, in due time, bigger consequences. Objectives: The objective of this research is to understand the impact of the insertion of Optometrists in the Portuguese primary health care services and to ascertain if the integration of these professionals would bring effectiveness in the provision of visual health care. Methods: The integration of Optometric professionals in the SNS has often been a matter of discussion. However, there are no studies in Portugal that demonstrate the effectiveness if those Professionals are integrated. Based on a study conducted in three countries, i.e., Great Britain, Germany and France, “Comparative Analysis of Delivery of Primary Eye Care in Three European Countries” (Thomas, et all., 2011), from the basic structure of optometric services in these countries, this thesis aimed to understand how these primary services are organized in Portugal. Results: The obtained data from electronic sources, such as the number of ophthalmologists in the SNS, the evolution of pending requests by priority on triage, among others, it was implicit, that the number ophthalmologists in the SNS is not enough in order to satisfy all the existing demand. Thus, optometry professionals could have an active role in solving this situation. Recent finding by the International Health Authorities, stated that the ideal ratio would be 1 ophthalmologist per 20 thousand inhabitants, however, taking into account the actual number of ophthalmologists working for the SNS, there is a shortage of 113 ophthalmologists, assuming they work 40 hours/week. The area of Ophthalmology is the second specialty with more demand (8.3%), and the average response time, in 2017, until the consultation is 180.2 days (6 months). Conclusion: Although we cannot provide concrete and quantifiable values about the effectiveness of the integration of the Optometrists in SNS, with the figures presented in this dissertation and with justifications regarding the parameters presented, we believe that the access to CPS would be facilitated with the recognition of these professionals by the SNS. In order to differentiate the role of each professional of visual health so that they can reach as many individuals as possible who are looking for this area and thus solve the maximum number of requests outstanding, help to diminish the waiting lists and improve the quality life of people
Although the medical resources in Portugal are easily available for everyone, ophthalmology services are often linked to huge waiting lists and disproportional response time, both in access to the first ophthalmology appointment or access to surgical care. This situation stands as one of the most critical, perseverant and hard problem to solve. The main reason for this situation is the fact that Portuguese eye care services do not include Optometrists, since they are not part of SNS. Regarding the implementation and development of primary eye care reforms, optometrists will play a key role, since the visual system is essential for our daily life. Throughout life, changes in our visual system must be prematurely detected and treated. The results and impact of these changes in the individual and in the society, warns us that is a big mistake not providing suitable primary care, that could prevent, in due time, bigger consequences. Objectives: The objective of this research is to understand the impact of the insertion of Optometrists in the Portuguese primary health care services and to ascertain if the integration of these professionals would bring effectiveness in the provision of visual health care. Methods: The integration of Optometric professionals in the SNS has often been a matter of discussion. However, there are no studies in Portugal that demonstrate the effectiveness if those Professionals are integrated. Based on a study conducted in three countries, i.e., Great Britain, Germany and France, “Comparative Analysis of Delivery of Primary Eye Care in Three European Countries” (Thomas, et all., 2011), from the basic structure of optometric services in these countries, this thesis aimed to understand how these primary services are organized in Portugal. Results: The obtained data from electronic sources, such as the number of ophthalmologists in the SNS, the evolution of pending requests by priority on triage, among others, it was implicit, that the number ophthalmologists in the SNS is not enough in order to satisfy all the existing demand. Thus, optometry professionals could have an active role in solving this situation. Recent finding by the International Health Authorities, stated that the ideal ratio would be 1 ophthalmologist per 20 thousand inhabitants, however, taking into account the actual number of ophthalmologists working for the SNS, there is a shortage of 113 ophthalmologists, assuming they work 40 hours/week. The area of Ophthalmology is the second specialty with more demand (8.3%), and the average response time, in 2017, until the consultation is 180.2 days (6 months). Conclusion: Although we cannot provide concrete and quantifiable values about the effectiveness of the integration of the Optometrists in SNS, with the figures presented in this dissertation and with justifications regarding the parameters presented, we believe that the access to CPS would be facilitated with the recognition of these professionals by the SNS. In order to differentiate the role of each professional of visual health so that they can reach as many individuals as possible who are looking for this area and thus solve the maximum number of requests outstanding, help to diminish the waiting lists and improve the quality life of people
Description
Keywords
Cuidados Primários de Saúde Oftalmologia Optometrista Serviço Nacional de Saúde