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Yingfeng Zheng, Decai Wang, Mingguang He; Variability in Access to Hospital Eye Care in Southern China. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6107.
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To examine geographic variation in patient access to hospital eye care services and to examine determinants of these services in Southern China.
In April to August 2010, a questionnaire survey was carried out to investigate the availability of medical and surgical eye care services in fiscal year 2009 in all regional (secondary) and tertiary hospitals in Guangdong Province, southern China. A hospital was considered to have eye care services when there were registered ophthalmologists serving in the hospital. Hospital locations were classified as rural and urban regions.
A total of 348 of the surveyed hospitals provided valid data for analysis, giving a 78% response rate. A total of 100% of urban regions and 83.8% of rural regions provided eye care service. There was no significant difference in the availability of manual small-incision cataract surgery between rural and urban regions (77.9% vs. 88.9%), but rural hospitals were much less likely to provide advanced surgical procedures (vitreoretinal surgery: 10.3% in rural vs. 77.8% in urban; phacoemulsification: 45.6% vs. 94.4%; corneal transplant: 7.3% vs. 50.0%) and emergency eye care (88.2% vs. 100%). Factors significantly associated (p < 0.05) with hospital eye care included hospital levels (provincial, city and county levels) and geographical characteristics (including gross domestic product (GDP), individual earnings and population size). For-profit hospitals were more likely to provide more profitable care (e.g., LASIK and laser vision correction) when compared with public hospitals.
One-fifth of the rural hospitals do not establish eye care service, and there is a wide variation in access to surgical eye care between rural and urban settings. These findings indicate a need for training programs, capacity building and improvement in quality of infrastructure in rural China.
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