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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 #6
  1. Nathan Congdon (ncongdon{at}cuhk.edu.hk),
  2. Srinivas K Rao (skrao{at}cuhk.edu.hk),
  3. Kai Choi (kchoi{at}cuhk.edu.hk),
  4. Weizhao Wang (wzw{at}jsiec.org),
  5. Shaofang Lin (sflin{at}jsiec.org),
  6. Shaomian Chen (smc{at}jsiec.org),
  7. LJ Chen (ljc{at}jsiec.org),
  8. K Liu (kl{at}jsiec.org),
  9. IC Hu (ich{at}jsiec.org),
  10. Dennis S. Lam (dennislam_pub{at}cuhk.edu.hk)
  1. Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kon, China
  2. Chinese University of Hong Kong, Hong Kong
  3. CUHK, Hong Kong
  4. JSIEC, China
  5. Sanrao Hospital, China
  6. Sanrao Village Hospital, China
  7. JSIEC, China
  8. JSIEC, China
  9. JSIEC, China
  10. CUHK, Hong Kong

    Abstract

    Purpose: To study patient sources of knowledge about cataract surgical services, and strategies for financing surgery in rural China.

    Design: Cross-sectional case series.

    Methods: Persons undergoing cataract surgery by local surgeons in a government, village-level facility in Sanrao, Guangdong between 8 August and 31 December 2005 were examined and underwent standardized interviews an average of 12 months after surgery.

    Results: Among 313 eligible operated persons, 239 (76%) completed the questionnaire. Subjects had a mean age of 69.9 +/- 10.2 years, 36.4% (87/239) were male, and 87.0% (208/239) had been blind (presenting visual acuity <= 6/60) prior to surgery. Word of mouth advertising was particularly important: 198 (85.0%) of subjects knew a person who had undergone cataract surgery, of whom 191 (96.5%) had had cataract surgery at Sanrao itself. Over 70% of subjects (166/239) watched TV daily, whereas 80.0% (188/239) "never" read the newspaper. Nearly two-thirds of suggestions from participants (n = 211, 59.6%) favored either TV advertisements or word-of-mouth to publicize the program. While the son or daughter had paid for surgery in over 70% of cases (164/233), the patient's having paid without help was the sole predictor of undergoing second-eye surgery (OR 2.27 (1.01 - 5.0, P = 0.04)).

    Discussion: Strategies to increase cataract surgical uptake in rural China may benefit from enhancing word of mouth advertising (such as with pseudophakic motivators), utilizing television where affordable and micro-credit or other programs to enable patients to pay on their own, thus increasing uptake of second-eye surgery.

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