ACCESSIBILITY OF SPECIALIZED OPHTHALMOLOGICAL CARE FOR VARIOUS SOCIAL GROUPS OF THE POPULATION: BARRIERS AND WAYS TO OVERCOME THEM
DOI:
https://doi.org/10.11603/1681-2786.2026.1.16097Keywords:
ophthalmology care; accessibility of health services; health barriers; vulnerable populations; social inequality; telemedicine; public health.Abstract
Purpose. Systematization of current scientific data on barriers to access to specialized ophthalmological care for different social groups of the population and analysis of effective strategies for overcoming them. Materials and Methods. A systematic review of the literature was conducted in the PubMed, Web of Science, Scopus and Google Scholar databases for 2014–2024. The search was carried out using keywords related to the availability of ophthalmological care, barriers and vulnerable population groups. The analysis included 22 publica- tions that met the criteria of quality and relevance. The analysis was conducted by thematic categories: types of barriers (economic, geographical, socio-cultural, organizational), vulnerable population groups, effective interven- tions and their results. Results. Four main groups of accessibility barriers were identified: economic (cost of services as a significant burden on the population, indirect costs), geographical (remoteness of medical facilities, especially in rural areas, shortage of specialists, especially in low-income countries), socio-cultural (low awareness of the importance of regular check-ups, cultural beliefs, language barriers) and organizational (long waiting times, inconvenient sched- ules, insufficient access of patients to necessary treatment, even with free services). The most vulnerable groups are the elderly (unmet needs 35%), the population of rural areas (average distance to a specialist 87 km), low- income individuals (risk of access restrictions 3.5 times higher), ethnic minorities (risk of late detection of glaucoma 2.1 times higher) and migrants. Effective strategies for overcoming the barriers include telemedicine (increasing access by 40–150%), mobile ophthalmology clinics (60–200%), financial subsidies (35–80%), educational pro- grams (20–45%), and integration of screening into primary health care (25–60%). Conclusions. The availability of specialized ophthalmology care is limited by a complex of interconnected barriers that require integrated interventions. The most effective are comprehensive approaches that simultane- ously address several types of barriers, taking into account the specifics of vulnerable populations. Telemedicine and mobile clinics demonstrate high cost-effectiveness in overcoming geographical barriers, but the risks of digital inequality must be taken into account.
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