Análise do percurso terapêutico de idosos portadores de catarata: pesquisa nacional de saúde, Brasil, 2019

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Data
2025-01-01
Autores
Coelho, Roberta Goltara
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Universidade Federal do Espírito Santo
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Introduction: Cataracts are the leading cause of reversible blindness and represent a major public health challenge in Brazil. Associated with population aging and social inequalities, the disease affects millions of people and has a significant impact on the Unified Health System (SUS). There is a scarcity of national analyses focusing on the therapeutic itinerary (care pathway) for individuals with cataracts. This gap can be addressed using data from the 2019 National Health Survey (PNS). Such analyses can contribute to identifying the magnitude of the condition and the differences in access to diagnosis and surgical treatment in Brazil. Objectives: To determine the prevalence of cataract diagnosis and associated factors, as well as the indication and effective performance of corrective surgery among Brazilian residents aged 60 and over. Methods: This is a cross-sectional, population-based study using data from the 2019 National Health Survey (PNS). The prevalence rates of cataract diagnosis, surgical indication, and surgical undertaking were calculated. Crude and adjusted Prevalence Ratios (PRs) were estimated using Poisson regression with robust variance for sociodemographic and regional factors. The final sample included 22,728 older adults. Results: Among the study participants, 40.4% (95% CI: 39.7–41.1) had a clinical diagnosis of cataract. Among these, the largest proportion (83.3%; 95% CI: 82.5–84.1) received an indication for surgical treatment, which demonstrates the recognition of the therapeutic need. However, a relevant barrier was observed in access to the subsequent stage: only 73.2% (95% CI: 72.1–74.2) of individuals with an indication for surgery actually underwent the procedure. Thus, it was found that more than a quarter (26.9%; 95% CI: 25.8–27.9) of cases requiring intervention did not complete the care pathway. Final considerations: This study highlighted the high prevalence of cataracts among older adults in Brazil and the barriers to accessing surgery, marked by social and regional inequalities. The findings reinforce the need to strengthen primary care, modernize regulatory mechanisms, and expand funding for eye health to ensure equity and reduce the burden of preventable blindness in the country.
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