Willingness to Pay for Cataract Surgery in Rural Southern China

Purpose: To study willingness to pay for cataract surgery, and its associations, in Southern China. Design: Cross-sectional willingness-to-pay interview incorporating elements of the open-ended and bidding formats. Participants: Three-hundred thirty-nine persons presenting for cataract screening in Yangjiang, China, with presenting visual acuity (VA) ≤ 6/60 in either eye due to cataract. Methods: Subjects underwent measurement of their VA and a willingness-to-pay interview. Age, gender, literacy, education, and annual income also were recorded. Main Outcome Measures: Maximum amount that the subjects would be willing to pay for cataract surgery. Results: Among 325 (95.9%) subjects completing the interview, 169 (52.0%) were 70 years or older, 213 (65.5%) were women, and 217 (66.8%) had an annual income of <5000 renminbi (5000 = US $625). Eighty percent (n = 257) of participants were willing to pay something for surgery (mean, 442±444 renminbi [US $55±55]). In regression models, older subjects were willing to pay less (8 renminbi [US $1] per year of age; P = 0.01). Blind subjects were significantly more likely (odds ratio, 5.7; 95% confidence interval, 1.7-19.3) to pay anything for surgery, but would pay on average 255 renminbi (US $32) less (P = 0.004). Persons at the highest annual income level (>10 000 renminbi [US $1250]) would pay $50 more for surgery than those at the lowest level (<5000 renminbi) (P = 0.0003). The current cost of surgery in this program is 500 renminbi (US $63). Conclusions: Sustainable programs will need to attract younger, more well-to-do persons with better vision, while still providing access to the neediest patients.