Abstract
Purpose: :
To identify the most efficient method to increase the number of cataract surgeries in rural China by a community-based randomized interventional study
Methods: :
In Pucheng County Hospital, Shanxi Province, in western and rural China, 432 patients aged ≥50 years with operable cataracts did not undergo cataract surgery 3 months after participation in a cataract outreach screening program. We managed to contact 355 (82.2%) of them in person and randomly assigned them into 4 groups. Participants in Group 1 (n=86) were given an informative reminder through telephone or personal interview by a trained staff to undergo low-cost cataract surgery. Group 2 (n=86) was offered the reminder and free surgery. Group 3 (n=90) was offered the reminder and free surgery and also received a reimbursement for transport expenses. Instead of reimbursement, Group 4 (n=93) were provided with free rides from home to hospital and given reminder and free surgery.
Results: :
Totally 94 (26.5%) patients underwent cataract surgery after the intervention. In Group 1, 13 (14.4%) patients underwent surgery, significantly lower than the number in Group 2 (25, 27.8%, P=0.027), Group 3 (28, 31.1%, P=0.012) and Group 4 (26, 28%, P=0.038). There were no significant differences between Groups 2 and 3 (P=0.768) or between Groups 2 and 4 (P=0.869).
Conclusions: :
An informative reminder could improve the numbers of patients to receive cataract surgery. But provision of free cataract surgeries definitely enhanced the number. Either reimbursement for or provision of transportation has little impact to increase the number of patients to receive cataract surgery.
Clinical Trial: :
Centre for clinical trials, CUHK, CUHK_CCT00285
Keywords: cataract • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials