A two-site, population-based study of barriers to cataract surgery in rural China

Qiuxia Yin, Ailian Hu, Yuanbo Liang, Jian Zhang, Mingguang He, Dennis S C Lam, Jian Ge, Ningli Wang, David S Friedman, Jialiang Zhao, Nathan Congdon

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)1069-1075
Number of pages7
JournalInvestigative Ophthalmology and Visual Science
Volume50
Issue number3
DOIs
StatePublished - Mar 2009

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Cataract
China
Population
Costs and Cost Analysis
Visual Acuity
Multivariate Analysis
Interviews

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience
  • Medicine(all)

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A two-site, population-based study of barriers to cataract surgery in rural China. / Yin, Qiuxia; Hu, Ailian; Liang, Yuanbo; Zhang, Jian; He, Mingguang; Lam, Dennis S C; Ge, Jian; Wang, Ningli; Friedman, David S; Zhao, Jialiang; Congdon, Nathan.

In: Investigative Ophthalmology and Visual Science, Vol. 50, No. 3, 03.2009, p. 1069-1075.

Research output: Contribution to journalArticle

Yin, Q, Hu, A, Liang, Y, Zhang, J, He, M, Lam, DSC, Ge, J, Wang, N, Friedman, DS, Zhao, J & Congdon, N 2009, 'A two-site, population-based study of barriers to cataract surgery in rural China', Investigative Ophthalmology and Visual Science, vol. 50, no. 3, pp. 1069-1075. https://doi.org/10.1167/iovs.08-2783
Yin, Qiuxia ; Hu, Ailian ; Liang, Yuanbo ; Zhang, Jian ; He, Mingguang ; Lam, Dennis S C ; Ge, Jian ; Wang, Ningli ; Friedman, David S ; Zhao, Jialiang ; Congdon, Nathan. / A two-site, population-based study of barriers to cataract surgery in rural China. In: Investigative Ophthalmology and Visual Science. 2009 ; Vol. 50, No. 3. pp. 1069-1075.
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T1 - A two-site, population-based study of barriers to cataract surgery in rural China

AU - Yin, Qiuxia

AU - Hu, Ailian

AU - Liang, Yuanbo

AU - Zhang, Jian

AU - He, Mingguang

AU - Lam, Dennis S C

AU - Ge, Jian

AU - Wang, Ningli

AU - Friedman, David S

AU - Zhao, Jialiang

AU - Congdon, Nathan

PY - 2009/3

Y1 - 2009/3

N2 - 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.

AB - 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.

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