Andersen’s utilization model for cataract surgical rate and empirical evidence from economically-developing areas

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Andersen’s utilization model for cataract surgical rate and empirical evidence from economically-developing areas


JournalBMC Ophthalmology
Article typeJournal research article – Clinical research
Publication date – Feb – 2021
Authors – Senlin Lin, Yingyan Ma, Zhiyuan Hou, Nathan Congdon, Lina Lu, Haidong Zou
KeywordsCataract surgical rate, Low-and middle-income countries
Open access – Yes
SpecialityOphthalmology
World region Central Africa, Eastern Africa, Eastern Asia, Northern Africa, Southern Africa, Western Africa

Language – English
Submitted to the One Surgery Index on March 6, 2021 at 7:51 am
Abstract:

Abstract
Background
Un-operated cataract is the leading cause of vision loss worldwide, responsible for 33% of visual impairment, and half of global blindness. The study aimed to build a fast evaluation method utilizing Andersen’s utilization framework and identify predictors of cataract surgical rate in sub-Saharan Africa and China.

Methods
The study was a cross-over ecological epidemiology study with a total of 19 countries in sub-Saharan Africa, and 31 provinces in China. Information was extracted from public data and published studies. Linear regression and structural equation modeling with Bootstrap were used to analyze predictors of CSR and their pathways to impact in sub-Saharan Africa and China separately.

Results
Cataract surgical resources in sub-Saharan Africa were linearly correlated with CSR (β = 0.74, 95% CI: 0.09, 0.91), while GDP/P didn’t impact cataract surgical resources (β = 0.29, 95% CI: − 0.12, 0.75). In China, residents’ average ability to pay was confirmed as the mediator between GDP/P and CSR (p = 0.32, RMSEA = 0.07; βCSR-paying = 0.77, 95% CI: 0.25, 0.90; βpaying-GDP/P = 0.89, 95% CI: 0.82, 0.93).

Conclusions
In sub-Saharan Africa, CSR is determined by health care provision. Local economic development may not directly influence CSR. Therefore, international assistance aimed to providing free cataract surgery directly is crucial. In China, CSR is determined principally by health care demand (ability to pay). To increase CSR in underserved areas of China, ability to pay must be enhanced through social insurance, and reduced surgical fees.

OSI Number – 20956

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