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Willingness to pay for cataract surgery and associated factors among cataract patients in Outreach Site, North West Ethiopia. PLoS One 2021; 16:e0248618. [PMID: 33760830 PMCID: PMC7990211 DOI: 10.1371/journal.pone.0248618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 03/02/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction In Ethiopia, cataract surgery is mainly provided by donors free of charge through outreach programs. Assessing willingness to pay for patients for cataract surgery will help explain how the service is valued by the beneficiaries and design a domestic source of finance to sustain a program. Although knowledge concerning willingness to pay for cataract surgery is substantive for developing a cost-recovery model, the existed knowledge is limited and not well-addressed. Therefore, the study aimed to assess willingness to pay for cataract surgery and associated factors among cataract patients in Outreach Site, North West Ethiopia. Methods A cross-sectional outreach-based study was conducted on 827 cataract patients selected through a simple random sampling method in Tebebe Gion Specialized Hospital, North West Ethiopia, from 10/11/2018 to 14/11/2018. The data were collected using a contingent valuation elicitation approach to elicit the participants’ maximum willingness to pay through face to face questionnaire interviews. The descriptive data were organized and presented using summary statistics, frequency distribution tables, and figures accordingly. Factors assumed to be associate with a willingness to pay were identified using a Tobit regression model with a p-value of <0.05 and confidence interval (CI ≠ 0). Results The study involved 827 cataract patients, and their median age was 65years. About 55% of the participants were willing to pay for the surgery. The average amount of money willing to pay was 17.5USD (95% CI; 10.5, 35.00) and It was significantly associated with being still worker (β = 26.66, 95% CI: 13.03, 40.29), being educated (β = 29.16, 95% CI: 2.35, 55.97), free from ocular morbidity (β = 28.48, 95% CI: 1.08, 55.90), duration with the condition, (β = -1.69, 95% CI: -3.32, -0.07), admission laterality (β = 21.21, 95% CI: 3.65, 38.77) and remained visual ability (β = -0.29, 95% CI (-0.55, -0.04). Conclusions Participants’ willingness to pay for cataract surgery in outreach Sites is much lower than the surgery’s actual cost. Early intervention and developing a cost-recovery model with multi-tiered packages attributed to the neediest people as in retired, less educated, severely disabled is strategic to increase the demand for service uptake and service accessibility.
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Gilbert C, Keay L, Palagyi A, Do VQ, McCluskey P, White A, Carnt N, Stapleton F, Laba TL. Investigation of attributes which guide choice in cataract surgery services in urban Sydney, Australia. Clin Exp Optom 2018; 101:363-371. [PMID: 29345003 DOI: 10.1111/cxo.12653] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 11/28/2017] [Accepted: 11/29/2017] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND It is critical to consult patients to develop patient-centred cataract surgery care. We aimed to identify attributes patients consider when making decisions about cataract surgery in an Australian context, where both publicly and privately funded surgery are available. This is the first step in investigating how decisions are made about cataract surgery services. METHODS This observational qualitative study was undertaken in two public hospitals and one private practice in Sydney, Australia. The study involved 19 women and men with age-related cataracts and no previous cataract surgery, aged > 18 years, able to speak conversational English or Mandarin. A multi-stage attribute development process was followed, including: literature review, semi-structured interviews with surgery candidates in three eye clinics, and review by an expert panel. The main outcome measures were primary attributes for making choices about cataract surgery. RESULTS Wait time, cost, institutional reputation, surgeon experience and travel time were identified as principal attributes; lower value was placed on consultation length and accessibility. Non-English speaking participants indicated greater interest in pre-operative information than English speakers, but expressed trust in the Australian healthcare system. CONCLUSIONS Findings suggest individuals prioritise attributes which consume time or incur costs when accessing care (wait time, cost and travel time). They also consider factors associated with the outcome of their cataract surgery (surgeon experience and institutional reputation). Similar to other decision-making processes, patients are likely to trade between these different attributes depending on their personal preferences and circumstances.
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Affiliation(s)
- Celeste Gilbert
- The George Institute for Global Health, The University of New South Wales, Newtown, New South Wales, Australia
| | - Lisa Keay
- The George Institute for Global Health, The University of New South Wales, Newtown, New South Wales, Australia
| | - Anna Palagyi
- The George Institute for Global Health, The University of New South Wales, Newtown, New South Wales, Australia
| | - Vu Quang Do
- The George Institute for Global Health, The University of New South Wales, Newtown, New South Wales, Australia.,School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia
| | - Peter McCluskey
- Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Andrew White
- Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Westmead Institute for Medical Research, Sydney, New South Wales, Australia.,Department of Ophthalmology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Nicole Carnt
- Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Fiona Stapleton
- School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia
| | - Tracey-Lea Laba
- The George Institute for Global Health, The University of New South Wales, Newtown, New South Wales, Australia.,Menzies Centre for Health Policy, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
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Radhakrishnan M, Venkatesh R, Valaguru V, Frick KD. Economic and social factors that influence households not willing to undergo cataract surgery. Indian J Ophthalmol 2016; 63:594-9. [PMID: 26458477 PMCID: PMC4652250 DOI: 10.4103/0301-4738.167116] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Literature investigating barriers to cataract surgery is mostly done from the patient's point of view. However, many medical decisions are jointly taken by household members, especially in developing countries such as India. We investigated from the household head's (or representative's) perspective, households’ view on those not willing to undergo cataract surgery along with the economic and social factors associated with it. Materials and Methods: A cross-sectional survey of four randomly selected village clusters in rural areas of Theni district, Tamil Nadu, India, was conducted to elicit the willingness to pay for cataract surgery by presenting “scenarios” that included having or not having free surgery available. The presentation of scenarios allowed the identification of respondents who were unwilling to undergo surgery. Logistic regression was used to estimate relationships between economic and social factors and unwillingness to undergo cataract surgery. Results: Of the 1271 respondents, 49 (3.85%) were not willing to undergo surgery if they or their family members have cataract even if free surgery were available. In the regression results, those with good understanding of cataract and its treatment were less likely to be unwilling to undergo cataract surgery. Those not reporting household income were more likely to be unwilling to undergo cataract surgery. Conclusions: As a good understanding of cataract was an important predictor of willingness to undergo cataract surgery, health education on cataract and its intervention can improve uptake.
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Affiliation(s)
| | - Rengaraj Venkatesh
- Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Puducherry, India
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Lin H, Lin D, Long E, Jiang H, Qu B, Tang J, Lin Y, Chen J, Wu X, Lin Z, Li X, Liu Z, Zhang B, Chen H, Tan X, Luo L, Liu Y, Chen W. Patient participation in free cataract surgery: a cross-sectional study of the low-income elderly in urban China. BMJ Open 2016; 6:e011061. [PMID: 27084286 PMCID: PMC4838725 DOI: 10.1136/bmjopen-2016-011061] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To explore the characteristics of the low-income elderly who underwent free cataract surgery and to determine the degree of patient satisfaction with the free cataract surgery programme in urban China. METHODS A free cataract surgery management workflow was designed as a poverty relief project in Guangzhou. In this study, participants who underwent free cataract surgery between January and August 2014 received a telephone interview based on a structured questionnaire. Data were collected on patient demographics, resources, health conditions, reasons for undergoing the free surgery and overall evaluation of the free cataract surgery programme. RESULTS Among the 833 participants, the mean surgical age was 76.85±7.46 years (95% CI 76.34 to 77.36), and the male to female ratio was 385:448. The majority (94.31%, 746/791) of patients resided in the main urban districts. Patients underwent surgery 61.08±60.15 months (95% CI 56.17 to 66.00) after becoming aware of the cataract, although 66.83% of them reported that their daily lives were influenced by cataracts. Only 21.5% of the respondents underwent physical examinations that included regular eye screening, and only 6.30% were highly educated patients. Financial problems were the primary reason cited by patients for participating in the free surgery programme. Those patients with a monthly family income of 1000-2999¥ (US$161-482) per capita constituted the largest patient population. The free clinics in the parks and the free cataract surgery were highly rated (9.46 and 9.11 of 10 points) by the beneficiaries. CONCLUSIONS The telephone survey revealed a high level of patient satisfaction regarding the free cataract surgery programme. Most of the patients who participated in the programme resided in major urban districts and had poor health awareness and a low level of education. The information provided by this study is crucial for improving and expanding the management of free cataract surgery programmes. TRIAL REGISTRATION NUMBER NCT02633865; Post-results.
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Affiliation(s)
- Haotian Lin
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Duoru Lin
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Erping Long
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Haofeng Jiang
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Bo Qu
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Jinzhu Tang
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Yingfen Lin
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Jingjing Chen
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Xiaohang Wu
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Zhuoling Lin
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Xiaoyan Li
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Zhenzhen Liu
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Bo Zhang
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Hui Chen
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Xuhua Tan
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Lixia Luo
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Yizhi Liu
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Weirong Chen
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
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