A Two-Site, Population-Based Study of Barriers to Cataract Surgery in Rural China
Open Access
- 1 March 2009
- journal article
- research article
- Published by Association for Research in Vision and Ophthalmology (ARVO) in Investigative Opthalmology & Visual Science
- Vol. 50 (3), 1069-1075
- https://doi.org/10.1167/iovs.08-2783
Abstract
Purpose. China has among the lowest cataract surgical rates in Asia. This study was conducted to identify barriers to cataract surgery in rural China. methods. All subjects having undergone cataract surgery and persons with presenting visual acuity ≤6/60 (in Yangjiang) or ≤6/18 (in Handan) in ≥1 eye due to nonsurgically treated cataract were identified in two population-based studies in southern (Yangjiang) and northern (Handan) China. The subjects were administered a questionnaire assessing attitudes in four areas constituting potential barriers to surgery: knowledge about cataract, perceptions of local surgical quality, transportation and cost, and available resources. results. Interviews were completed on 71% to 86% of eligible subjects in both sites. Interviewed subjects did not differ significantly from nonrespondents with regard to age, sex, and presenting acuity in the better-seeing eye. A total of 214 (80.4%) nonsurgical and 131 (76.6%) surgical participants were interviewed, with a mean age of 71.8 ± 8.0 and 73.7 ± 7.4 years, respectively (P > 0.1). Among the nonsurgical subjects, 67.8% were blind (presenting vision, ≤6/60) in ≥1 eye due to cataract, whereas among the surgical participants, 25.2% remained blind in the eye that had undergone surgical removal of the cataract. In a multivariate analysis adjusted for age, sex, and site, increased knowledge and higher estimates of the quality of surgery were associated with having had surgery, whereas cost and transportation scores were not. conclusions. Lack of knowledge about cataract and concerns about the quality of local services appear to be the principal barriers to cataract surgery in rural China.Keywords
This publication has 5 references indexed in Scilit:
- Sources of patient knowledge and financing of cataract surgery in rural China: the Sanrao Study of Cataract Outcomes and Up-Take of Services (SCOUTS), Report 6British Journal of Ophthalmology, 2008
- Willingness to Pay for Cataract Surgery in Rural Southern ChinaOphthalmology, 2007
- Geography of Africa biomedical publications: An analysis of 1996–2005 PubMed papersInternational Journal of Health Geographics, 2007
- Willingness to pay for cataract surgery in two regions of TanzaniaBritish Journal of Ophthalmology, 2006
- High-volume surgery in developing countriesEye, 2005