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PLoS One. 2017 Mar 1;12(3):e0172342. doi: 10.1371/journal.pone.0172342. eCollection 2017.

Effective cataract surgical coverage: An indicator for measuring quality-of-care in the context of Universal Health Coverage.

Author information

1
School of Social Sciences, Faculty of Arts and Social Sciences, University of New South Wales, Sydney, New South Wales, Australia.
2
School of Population Health, University of Auckland, Auckland, New Zealand.
3
Department Clinical Research, Faculty Infectious & Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
4
International Agency for the Prevention of Blindness, London, United Kingdom.
5
Health Information Services, Nijenburg 32, Grootebroek, Netherlands.

Abstract

OBJECTIVE:

To define and demonstrate effective cataract surgical coverage (eCSC), a candidate UHC indicator that combines a coverage measure (cataract surgical coverage, CSC) with quality (post-operative visual outcome).

METHODS:

All Rapid Assessment of Avoidable Blindness (RAAB) surveys with datasets on the online RAAB Repository on April 1 2016 were downloaded. The most recent study from each country was included. By country, cataract surgical outcome (CSOGood, 6/18 or better; CSOPoor, worse than 6/60), CSC (operated cataract as a proportion of operable plus operated cataract) and eCSC (operated cataract and a good outcome as a proportion of operable plus operated cataract) were calculated. The association between CSC and CSO was assessed by linear regression. Gender inequality in CSC and eCSC was calculated.

FINDINGS:

Datasets from 20 countries were included (2005-2013; 67,337 participants; 5,474 cataract surgeries). Median CSC was 53.7% (inter-quartile range[IQR] 46.1-66.6%), CSOGood was 58.9% (IQR 53.7-67.6%) and CSOPoor was 17.7% (IQR 11.3-21.1%). Coverage and quality of cataract surgery were moderately associated-every 1% CSC increase was associated with a 0.46% CSOGood increase and 0.28% CSOPoor decrease. Median eCSC was 36.7% (IQR 30.2-50.6%), approximately one-third lower than the median CSC. Women tended to fare worse than men, and gender inequality was slightly higher for eCSC (4.6% IQR 0.5-7.1%) than for CSC (median 2.3% IQR -1.5-11.6%).

CONCLUSION:

eCSC allows monitoring of quality in conjunction with coverage of cataract surgery. In the surveys analysed, on average 36.7% of people who could benefit from cataract surgery had undergone surgery and obtained a good visual outcome.

PMID:
28249047
PMCID:
PMC5382971
DOI:
10.1371/journal.pone.0172342
[Indexed for MEDLINE]
Free PMC Article

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