Limits...
Effective cataract surgical coverage: An indicator for measuring quality-of-care in the context of Universal Health Coverage

View Article: PubMed Central - PubMed

ABSTRACT

Objective: To define and demonstrate effective cataract surgical coverage (eCSC), a candidate UHC indicator that combines a coverage measure (cataract surgical coverage, CSC) with quality (post-operative visual outcome).

Methods: All Rapid Assessment of Avoidable Blindness (RAAB) surveys with datasets on the online RAAB Repository on April 1 2016 were downloaded. The most recent study from each country was included. By country, cataract surgical outcome (CSOGood, 6/18 or better; CSOPoor, worse than 6/60), CSC (operated cataract as a proportion of operable plus operated cataract) and eCSC (operated cataract and a good outcome as a proportion of operable plus operated cataract) were calculated. The association between CSC and CSO was assessed by linear regression. Gender inequality in CSC and eCSC was calculated.

Findings: Datasets from 20 countries were included (2005–2013; 67,337 participants; 5,474 cataract surgeries). Median CSC was 53.7% (inter-quartile range[IQR] 46.1–66.6%), CSOGood was 58.9% (IQR 53.7–67.6%) and CSOPoor was 17.7% (IQR 11.3–21.1%). Coverage and quality of cataract surgery were moderately associated—every 1% CSC increase was associated with a 0.46% CSOGood increase and 0.28% CSOPoor decrease. Median eCSC was 36.7% (IQR 30.2–50.6%), approximately one-third lower than the median CSC. Women tended to fare worse than men, and gender inequality was slightly higher for eCSC (4.6% IQR 0.5–7.1%) than for CSC (median 2.3% IQR -1.5–11.6%).

Conclusion: eCSC allows monitoring of quality in conjunction with coverage of cataract surgery. In the surveys analysed, on average 36.7% of people who could benefit from cataract surgery had undergone surgery and obtained a good visual outcome.

No MeSH data available.


Related in: MedlinePlus

Proportion of operated eyes with presenting visual acuity of 6/18 or                        better (CSOGood) or worse than 6/60 (CSOPoor) plotted                        against observed cataract surgical coverage (CSCpersons                            <6/60, %) in 20 countries, 2005–2013.                    WHO Targets established in 1998.[31].
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC5382971&req=5

pone.0172342.g001: Proportion of operated eyes with presenting visual acuity of 6/18 or better (CSOGood) or worse than 6/60 (CSOPoor) plotted against observed cataract surgical coverage (CSCpersons <6/60, %) in 20 countries, 2005–2013. WHO Targets established in 1998.[31].

Mentions: The WHO targets[31] for CSOGood (>80%) and CSOPoor (<5%) were not met in any country, although the extent to which targets were not met varied substantially between countries (Fig 1). There was moderate association between CSC and both outcomes—every 1% increase in CSC was associated with a 0.46% increase in CSOGood (p = 0.0012) and a 0.28% decrease in CSOPoor (p = 0.0036). The R2 values indicate that CSC alone explained 45% of the variation in CSOGood and 38% of the variation in CSOPoor.


Effective cataract surgical coverage: An indicator for measuring quality-of-care in the context of Universal Health Coverage
Proportion of operated eyes with presenting visual acuity of 6/18 or                        better (CSOGood) or worse than 6/60 (CSOPoor) plotted                        against observed cataract surgical coverage (CSCpersons                            <6/60, %) in 20 countries, 2005–2013.                    WHO Targets established in 1998.[31].
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5382971&req=5

pone.0172342.g001: Proportion of operated eyes with presenting visual acuity of 6/18 or better (CSOGood) or worse than 6/60 (CSOPoor) plotted against observed cataract surgical coverage (CSCpersons <6/60, %) in 20 countries, 2005–2013. WHO Targets established in 1998.[31].
Mentions: The WHO targets[31] for CSOGood (>80%) and CSOPoor (<5%) were not met in any country, although the extent to which targets were not met varied substantially between countries (Fig 1). There was moderate association between CSC and both outcomes—every 1% increase in CSC was associated with a 0.46% increase in CSOGood (p = 0.0012) and a 0.28% decrease in CSOPoor (p = 0.0036). The R2 values indicate that CSC alone explained 45% of the variation in CSOGood and 38% of the variation in CSOPoor.

View Article: PubMed Central - PubMed

ABSTRACT

Objective: To define and demonstrate effective cataract surgical coverage (eCSC), a candidate UHC indicator that combines a coverage measure (cataract surgical coverage, CSC) with quality (post-operative visual outcome).

Methods: All Rapid Assessment of Avoidable Blindness (RAAB) surveys with datasets on the online RAAB Repository on April 1 2016 were downloaded. The most recent study from each country was included. By country, cataract surgical outcome (CSOGood, 6/18 or better; CSOPoor, worse than 6/60), CSC (operated cataract as a proportion of operable plus operated cataract) and eCSC (operated cataract and a good outcome as a proportion of operable plus operated cataract) were calculated. The association between CSC and CSO was assessed by linear regression. Gender inequality in CSC and eCSC was calculated.

Findings: Datasets from 20 countries were included (2005&ndash;2013; 67,337 participants; 5,474 cataract surgeries). Median CSC was 53.7% (inter-quartile range[IQR] 46.1&ndash;66.6%), CSOGood was 58.9% (IQR 53.7&ndash;67.6%) and CSOPoor was 17.7% (IQR 11.3&ndash;21.1%). Coverage and quality of cataract surgery were moderately associated&mdash;every 1% CSC increase was associated with a 0.46% CSOGood increase and 0.28% CSOPoor decrease. Median eCSC was 36.7% (IQR 30.2&ndash;50.6%), approximately one-third lower than the median CSC. Women tended to fare worse than men, and gender inequality was slightly higher for eCSC (4.6% IQR 0.5&ndash;7.1%) than for CSC (median 2.3% IQR -1.5&ndash;11.6%).

Conclusion: eCSC allows monitoring of quality in conjunction with coverage of cataract surgery. In the surveys analysed, on average 36.7% of people who could benefit from cataract surgery had undergone surgery and obtained a good visual outcome.

No MeSH data available.


Related in: MedlinePlus