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Factors influencing the output of rural cataract surgical facilities in China: the SHARP study.

Abstract：

PURPOSE:To identify factors associated prospectively with increased cataract surgical rate (CSR) in rural Chinese hospitals. METHODS:Annual cataract surgical output was obtained at baseline and 24 months later from operating room records at 42 rural, county-level hospitals. Total local CSR (cases/million population/y), and proportion of CSR from hospital and local competitors were calculated from government records. Hospital administrators completed questionnaires providing demographic and professional information, and annual clinic and outreach screening volume. Independent cataract surgeons provided clinical information and videotapes of cases for grading by two masked experts using the Ophthalmology Surgical Competency Assessment Rubric (OSCAR). Uncorrected vision was recorded for 10 consecutive cataract cases at each facility, and 10 randomly-identified patients completed hospital satisfaction questionnaires. Total value of international nongovernmental development organization (INGDO) investment in the previous three years and demographic information on hospital catchment areas were obtained. Main outcome was 2-year percentage change in hospital CSR. RESULTS:Among the 42 hospitals (median catchment population 530,000, median hospital CSR 643), 78.6% (33/42) were receiving INGDO support. Median change in hospital CSR (interquartile range) was 33.3% (-6.25%, 72.3%). Predictors of greater increase in CSR included higher INGDO investment (P = 0.02, simple model), reducing patient dissatisfaction (P = 0.03, simple model), and more outreach patient screening (P = 0.002, simple and multiple model). CONCLUSIONS:Outreach cataract screening was the strongest predictor of increased surgical output. Government and INGDO investment in screening may be most likely to enhance output of county hospitals, a major goal of China's Blindness Prevention Plan.

journal_name

Invest Ophthalmol Vis Sci

journal_title

Investigative ophthalmology & visual science

authors

Chen T,Jin L,Zhou Z,Huang Y,Yan X,Liu T,Ong EL,Liu B,Huang W,Iezzi B,He M,Friedman DS,Congdon NG

doi

10.1167/iovs.14-16263

subject

Has Abstract

pub_date

2015-02-03 00:00:00

pages

1283-91

issue

eissn

0146-0404

issn

1552-5783

pii

iovs.14-16263

journal_volume

pub_type

杂志文章,多中心研究

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Factors influencing the output of rural cataract surgical facilities in China: the SHARP study.