A multicentric cross-sectional study measuring the equity of cataract surgical services in three high-volume eyecare organizations in North India: Equitable cataract surgical rate as a new indicator
| Autor: | Subeesh Kuyyadiyil, Vijay Pratap Singh Tomar, Ishaana Sood, Atanu Majumdar, Ken Bassett, Kunal Vikram Singh, Elesh Jain, Shalinder Sabherwal |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Visual acuity Cross-sectional study medicine.medical_treatment Visual impairment India Cataract Extraction preoperative visual acuity North india Blindness Cataract Prevalence Medicine Humans Retrospective Studies business.industry Public health cataract surgical rate public health Equity (finance) blind severe visual impairment Patient data Cataract surgery RE1-994 Ophthalmology Cross-Sectional Studies moderate visual impairment Female medicine.symptom business Demography |
| Zdroj: | Indian Journal of Ophthalmology, Vol 69, Iss 12, Pp 3498-3502 (2021) |
| ISSN: | 1998-3689 0301-4738 |
| Popis: | Purpose: Cataract remains the leading cause of blindness and visual impairment in most low-and middle-income countries, with the greatest burden borne by women. To achieve Global Action Plan targets, cataract programs must target people, especially women, with maximum need. This study examines whether cataract surgical programs in three major north Indian eyecare institutions are equitable and describes a refined indicator for reporting equity. Methods: Retrospective one-year cross-sectional study of cataract surgery utilization using routine administrative data from three north Indian eyecare institutions. Patient data were categorized by paying category, sex, and preoperative visual acuity. Comparisons were made between payment categories and sexes. Results: Out of the total number of patients operated, 86,230 were in the non-paying category and 56,738 in the paying category. Overall, 8.2% were blind, 21.1% were severely visual impaired (SVI) or worse, and 86.1% were moderate visual impaired (MVI) or worse. Non-paying patients had a significantly higher proportion of poorer visual categories compared to paying patients [(blind, 9.7% vs. 5.8%; SVI or worse, 24.6% vs. 15.8%; and MVI or worse, 89.1% vs. 81.6%, respectively, (P < 0.001)]. Women had significantly higher proportion of poorer visual categories than men [(blind, 8.9% vs. 7.4%, SVI or worse, 21.9% vs. 20.3% and MVI or worse 87.6 vs. 84.7%) (P < 0.001)]. Conclusion: The institutions primarily provided surgery to patients with maximum need: too poor to pay, low visual acuity, and women. Similar data from all service providers of a region can help estimate the proposed “equitable cataract surgical rate”: the proportion of patients operated with maximum need among those operated in a year. This can be used for targeting people in need. |
| Databáze: | OpenAIRE |
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