Visual impairment as a function of visual acuity in both eyes and its impact on patient reported preferences

10.1371/journal.pone.0081042PLoS ONE812-POLN

Future requirements for and supply of ophthalmologists for an aging population in Singapore

#### Background Singapore’s population, as that of many other countries, is aging; this is likely to lead to an increase in eye diseases and the demand for eye care. Since ophthalmologist training is long and expensive, early planning is essential. This paper forecasts workforce and training requirements for Singapore up to the year 2040 under several plausible future scenarios. #### Methods The Singapore Eye Care Workforce Model was created as a continuous time compartment model with explicit workforce stocks using system dynamics. The model has three modules: prevalence of eye disease, demand, and workforce requirements. The model is used to simulate the prevalence of eye diseases, patient visits, and workforce requirements for the public sector under different scenarios in order to determine training requirements. #### Results Four scenarios were constructed. Under the baseline business-as-usual scenario, the required number of ophthalmologists is projected to increase by 117% from 2015 to 2040. Under the current policy scenario (assuming an increase of service uptake due to increased awareness, availability, and accessibility of eye care services), the increase will be 175%, while under the new model of care scenario (considering the additional effect of providing some services by non-ophthalmologists) the increase will only be 150%. The moderated workload scenario (assuming in addition a reduction of the clinical workload) projects an increase in the required number of ophthalmologists of 192% by 2040. Considering the uncertainties in the projected demand for eye care services, under the business-as-usual scenario, a residency intake of 8–22 residents per year is required, 17–21 under the current policy scenario, 14–18 under the new model of care scenario, and, under the moderated workload scenario, an intake of 18–23 residents per year is required. #### Conclusions The results show that under all scenarios considered, Singapore’s aging and growing population will result in an almost doubling of the number of Singaporeans with eye conditions, a significant increase in public sector eye care demand and, consequently, a greater requirement for ophthalmologists

Multi-stakeholder perspectives in defining health services quality indicators and dimensions

__Objective__ This study aims to advance understanding of globally valid versus country-specific quality dimensions and indicators, as perceived by relevant stakeholders. It specifically addresses patient-level indicators for cataract surgery. __Design__ A mixed-methods case study comparing Singapore and The Netherlands __Setting__ Singapore (2017–2019) and The Netherlands (2014–2015). __Participants__ Stakeholder representatives of cataract care in Singapore and The Netherlands. __Intervention__ Based on the previously identified complete set of stakeholders in The Netherlands, we identified stakeholders of cataract care in Singapore. Stakeholder representatives then established a multi-stakeholder perspective on the quality of cataract care using a concept mapping approach. This yielded a multidimensional cluster map based on multivariate statistical analyses. Consensus-based quality dimensions were subsequently defined during a plenary session. Thereafter, Singaporean dimensions were matched with dimensions obtained in The Netherlands to identify commonalities and differences. __Main outcome measure__ Health-services quality dimensions of cataract care. Results 19 Singaporean stakeholders representing patients, general practitioners, ophthalmologists, nurses, care providers, researchers and clinical auditors defined health-services quality of cataract care using the following eight dimensions: clinical outcome, patient outcomes, surgical process, surgical safety, patient experience, access, cost and standards of care. Compared with the Dutch results, 61% of the indicators were allocated to dimensions of comparable names and compositions. Considerable differences also existed in the composition of some dimensions and the importance attached to indicators. __Conclusions and relevance__ This study on cataract care in Singapore and The Netherlands shows that cataract care quality measurement instruments can share a common international core. At the same time, it emphasises the importance of taking a country-specific multi-stakeholder approach to quality definition and measure

To the editor

10.1097/IAE.0b013e3182928b33Retina3371479-RETI

Author reply

10.1016/j.ophtha.2012.11.017Ophthalmology1204877-OPHT

Author reply

10.1016/j.ophtha.2013.01.034Ophthalmology12051105-1106OPHT

Factors associated with knowledge of diabetes in patients with type 2 diabetes using the diabetes knowledge test validated with Rasch analysis

10.1371/journal.pone.0080593PLoS ONE812e8059

Uj Kelet : zsidó politikai napilap

Cluj, Tel-Avi

An evaluation of the reliability and validity of the visual functioning questionnaire (VF-11) using rasch analysis in an Asian population

10.1167/iovs.08-2359Investigative Ophthalmology and Visual Science5062607-2613IOVS