Background
Methods
Study setting and population
District information
Land area (km2) | Population (million) | CSR in 2014 | Number of hospitals for cataract treatment | Number of doctors being able to do cataract surgery | |
---|---|---|---|---|---|
Baoshan | 270.99 | 2.024 | 2951 | 5 | 16 |
Xuhui | 54.76 | 1.110 | 4548 | 8 | 120 |
Total | 325.75 | 3.134 | 3750 | 13 | 136 |
Medical resources
Patients
Questionnaires
Statistical analyses
Results
Clinical information derived from questionnaire interview
Rural n = 1312 | Urban n = 1230 | P value | |
---|---|---|---|
PVA | 0.16 | ||
< 20/40–20/63 | 803(61.2%) | 758(61.5%) | |
20/63–20/200 | 312(23.8%) | 259(21.1%) | |
20/200–20/400 | 24(1.8%) | 24(2.0%) | |
< 20/400 | 173(13.2%) | 189(15.4%) | |
IOP (mmHg) | 16.9 ± 3.9 | 15.8 ± 4.0 | 0.12 |
Lens status | 0.004 | ||
cataract | 1084(82.6%) | 937(83.6%) | |
IOL | 129(10.5%) | 176(15.7%) | |
aphakic | 3(0.2%) | 3(0.3%) | |
others | 5(0.4%) | 5(0.4%) |
Information about gender, age, family income, education, medical insurance type, commute, satisfaction, awareness and district of patients who had received or not received cataract surgery
Cataract surgery history | |||
---|---|---|---|
Yes | No | P value | |
n = 404 | n = 1830 | ||
Gender [n(%)] | 0.0127 | ||
Male | 143 (15.6%) | 771 (84.4%) | |
Female | 261 (19.8%) | 1059 (80.2%) | |
Total | 404 (17.8%) | 1830 (82.2%) | |
Age [n(%)] | < 0.0001 | ||
50- < 60 | 30 (14.6%) | 176 (85.4%) | |
60- < 70 | 94 (12.8%) | 638 (87.2%) | |
70- < 80 | 133 (17.8%) | 614 (82.2%) | |
≥ 80 | 147(26.8%) | 402 (73.2%) | |
Total | 404 (17.8%) | 1830 (82.2%) | |
Disposable family Income per month [n(%)] | 0.5624 | ||
< 1000 RMB | 8 (11.6%) | 61 (88.4%) | |
1000–2999 RMB | 207 (18.4%) | 918 (81.6%) | |
3000–4999 RMB | 124 (18.2%) | 556 (81.8%) | |
≥ 5000 RMB | 65 (18.1%) | 295 (81.9%) | |
Total | 404 (17.8%) | 1830 (82.2%) | |
Education [n(%)] | 0.0323 | ||
illiteracy | 70 (16.9%) | 344 (83.1%) | |
Primary school | 103 (19.5%) | 424 (80.5%) | |
middle school | 179 (16.6%) | 902 (83.4%) | |
College and above | 52 (24.5%) | 160 (75.5%) | |
Total | 404 (17.7%) | 1830 (82.3%) | |
Medical Insurance [n(%)] | 0.0363 | ||
No insurance | 1 (5.6%) | 17 (94.4%) | |
Urban medical insurance | 372 (18.9%) | 1593 (81.1%) | |
Rural medical insurance | 21 (11.9%) | 156 (88.1%) | |
Non-local medical insurance | 10 (13.5%) | 64 (86.5%) | |
Total | 404 (17.8%) | 1830 (82.2%) | |
Transfer times [n(%)] | 0.0115 | ||
0 | 181 (15.7%) | 970 (84.3%) | |
1 | 164 (20.7%) | 630 (79.3%) | |
≥ 2 | 59 (20.4%) | 230 (79.6%) | |
Total | 404 (17.8%) | 1830 (82.2%) | |
Satisfaction about facilities of hospitals nearby [n(%)] | 0.0319 | ||
Very satisfied | 118 (21.1%) | 441 (78.9%) | |
Other | 286 (17.1%) | 1389 (82.9%) | |
Total | 404 (17.8%) | 1830 (82.2%) | |
Satisfaction about service of hospitals nearby [n(%)] | 0.0048 | ||
Very satisfied | 127 (22.0%) | 451 (78.0%) | |
Other | 277 (16.7%) | 1379 (83.3%) | |
Total | 404 (17.8%) | 1830 (82.2%) | |
District [n(%)] | 0.0004 | ||
Rural | 181 (15.4%) | 998 (84.6%) | |
Urban | 223 (21.1%) | 832 (78.9%) | |
Total | 404 (17.8%) | 1830 (82.2%) | |
aAwareness evaluation score | < 0.0001 | ||
Mean (standard deviation) | 55.0 (23.4) | 38.8 (24.2) | |
404 | 1830 |
District | P value | ||
---|---|---|---|
Rural (n = 160) | Urban (n = 180) | ||
Why haven’t you accepted cataract surgery previously before the survey? | < 0.0001 | ||
I did not know that my visual acuity was impaired by cataract. | 4 (3.3%) | 29 (17.5%) | |
I don’t think that cataract has much influence on my life. My present visual acuity still makes do. | 79 (65.3%) | 74 (44.6%) | |
I did not know that cataract could be treated by surgery. | 1(0.8%) | 5 (3.0%) | |
I am worried about the effect of cataract surgery, especially the possibility of resurgence. | 5 (4.1%) | 21 (12.7%) | |
I am worried about that I could not be able to work after surgery. | 0 (0.0%) | 11 (6.6%) | |
I am worried about that nobody would take care of me during perioperative period. | 0 (0.0%) | 4 (2.4%) | |
It was inconvenient for me to go to hospital and ask for help. | 2 (1.7%) | 3 (1.8%) | |
I don’t trust on the surgery treatment. | 0 (0.0%) | 2 (1.2%) | |
I could not afford the surgery cost. | 6 (5.0%) | 3 (1.8%) | |
Religion reasons | 0 (0.0%) | 0 (0.0%) | |
Others | 24 (19.8%) | 14 (8.4%) | |
Total | 121 | 166 |
Correlations between gender, age, family income, education, medical insurance type, commute, satisfaction, awareness, district and surgery status among cataract patients with vision impairment
Factors | Rural & urban | Rural | Urban | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
OR | 95% CI | P value | OR | 95% CI | P value | OR | 95% CI | P value | |||||
Gender | Female | reference | reference | reference | |||||||||
Male | 0.649 | 0.506 | 0.833 | 0.0007 | 0.635 | 0.439 | 0.918 | 0.0158 | 0.660 | 0.467 | 0.931 | 0.0178 | |
Age | 50- < 60 | reference | reference | reference | |||||||||
60–69 | 0.801 | 0.494 | 1.298 | 0.3675 | 0.627 | 0.340 | 1.155 | 0.1343 | 1.259 | 0.548 | 2.893 | 0.5876 | |
70–79 | 1.182 | 0.733 | 1.908 | 0.4931 | 0.875 | 0.469 | 1.632 | 0.6739 | 1.872 | 0.829 | 4.229 | 0.1313 | |
> 79 | 2.521 | 1.535 | 4.140 | 0.0003 | 1.841 | 0.947 | 3.582 | 0.0721 | 4.132 | 1.808 | 9.444 | 0.0008 | |
Income | ≤2999 | reference | reference | reference | |||||||||
3000–4999 | 0.720 | 0.545 | 0.950 | 0.0203 | 0.731 | 0.477 | 1.120 | 0.1501 | 0.709 | 0.486 | 1.032 | 0.0728 | |
≥ 5000 | 0.579 | 0.400 | 0.837 | 0.0036 | 0.904 | 0.484 | 1.688 | 0.7506 | 0.501 | 0.313 | 0.804 | 0.0042 | |
Education | illiteracy | reference | reference | reference | |||||||||
primary school | 1.282 | 0.880 | 1.867 | 0.1963 | 1.154 | 0.693 | 1.921 | 0.5814 | 1.485 | 0.831 | 2.652 | 0.1816 | |
middle school | 1.104 | 0.751 | 1.622 | 0.6159 | 0.923 | 0.536 | 1.589 | 0.7735 | 1.325 | 0.744 | 2.360 | 0.3391 | |
college and above | 1.375 | 0.831 | 2.275 | 0.2151 | 0.867 | 0.402 | 1.869 | 0.7151 | 2.141 | 1.043 | 4.392 | 0.0379 | |
Social insurance | without insurance &non-local insurance | 0.762 | 0.382 | 1.522 | 0.4419 | 0.747 | 0.330 | 1.693 | 0.4855 | 0.718 | 0.188 | 2.744 | 0.6284 |
urban health insurance | reference | reference | reference | ||||||||||
rural health insurance | 0.904 | 0.526 | 1.555 | 0.7158 | 0.812 | 0.446 | 1.479 | 0.4956 | 2.875 | 0.500 | 16.515 | 0.2366 | |
Hospital accessibility | through bus | reference | reference | reference | |||||||||
one transfer | 1.344 | 1.033 | 1.749 | 0.0278 | 1.143 | 0.762 | 1.716 | 0.5185 | 1.466 | 1.030 | 2.0872 | 0.0336 | |
≥ twice transfer | 1.419 | 0.988 | 2.039 | 0.0581 | 1.120 | 0.650 | 1.931 | 0.6826 | 1.760 | 1.068 | 2.901 | 0.0266 | |
Satisfaction about hospital facilities | others | reference | reference | reference | |||||||||
satisfied | 0.667 | 0.369 | 1.203 | 0.1780 | 0.654 | 0.284 | 1.506 | 0.3184 | 0.676 | 0.285 | 1.605 | 0.3747 | |
Satisfaction about medical service | others | reference | reference | reference | |||||||||
satisfied | 1.632 | 0.918 | 2.903 | 0.0952 | 1.363 | 0.617 | 3.012 | 0.4435 | 1.786 | 0.756 | 4.219 | 0.1858 | |
Awareness score | – | 1.034 | 1.028 | 1.040 | < 0.0001 | 1.039 | 1.030 | 1.047 | < 0.0001 | 1.031 | 1.023 | 1.039 | < 0.0001 |
District | Baoshan | reference | – | – | |||||||||
Xuhui | 1.524 | 1.181 | 1.967 | 0.0012 |