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
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 wheth...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Indian Journal of Ophthalmology |
| Subjects: | |
| Online Access: | http://www.ijo.in/article.asp?issn=0301-4738;year=2021;volume=69;issue=12;spage=3498;epage=3502;aulast=Sabherwal |
| _version_ | 1817985584770056192 |
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| author | Shalinder Sabherwal Subeesh Kuyyadiyil Vijay P S Tomar Ishaana Sood Kunal V Singh Elesh K Jain Atanu Majumdar Ken Bassett |
| author_facet | Shalinder Sabherwal Subeesh Kuyyadiyil Vijay P S Tomar Ishaana Sood Kunal V Singh Elesh K Jain Atanu Majumdar Ken Bassett |
| author_sort | Shalinder Sabherwal |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-13T23:59:57Z |
| format | Article |
| id | doaj.art-1920ad76a2e24631a8dd25338dfbc5af |
| institution | Directory Open Access Journal |
| issn | 0301-4738 1998-3689 |
| language | English |
| last_indexed | 2024-04-13T23:59:57Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Ophthalmology |
| spelling | doaj.art-1920ad76a2e24631a8dd25338dfbc5af2022-12-22T02:23:44ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892021-01-0169123498350210.4103/ijo.IJO_134_21A 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 indicatorShalinder SabherwalSubeesh KuyyadiyilVijay P S TomarIshaana SoodKunal V SinghElesh K JainAtanu MajumdarKen BassettPurpose: 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.http://www.ijo.in/article.asp?issn=0301-4738;year=2021;volume=69;issue=12;spage=3498;epage=3502;aulast=Sabherwalblindcataract surgical ratemoderate visual impairmentpreoperative visual acuitypublic healthsevere visual impairment |
| spellingShingle | Shalinder Sabherwal Subeesh Kuyyadiyil Vijay P S Tomar Ishaana Sood Kunal V Singh Elesh K Jain Atanu Majumdar Ken Bassett 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 Indian Journal of Ophthalmology blind cataract surgical rate moderate visual impairment preoperative visual acuity public health severe visual impairment |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | blind cataract surgical rate moderate visual impairment preoperative visual acuity public health severe visual impairment |
| url | http://www.ijo.in/article.asp?issn=0301-4738;year=2021;volume=69;issue=12;spage=3498;epage=3502;aulast=Sabherwal |
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