Charges for cataract surgery.
نویسندگان
چکیده
Dear Editor: Studies such as that carried out by He et al 1 are important to anyone interested in developing financially sustainable eye care services in less developed countries. We have studied acceptance of cataract surgery and willingness to pay for it in Tanzania and found interesting similarities and some differences in our population. As in China, those with the lowest visual acuity (VA) are not necessarily the most likely to accept or to be willing to pay for cataract surgery. In a population-based cohort in Tanzania, we found that acceptance of surgery (priced at US $14) was more likely among younger people but not among those with the worst VA. 2 Interestingly, in another study in which cataract surgery was offered free to clinic patients who were recommended to have it but said they were too poor to pay, only 22% took advantage of the offer, and this was not related to VA. 3 A startling contrast to our findings in Tanzania was the amount people were willing to pay in China. Despite the fact that the average monthly household incomes are very low in both places (roughly $28 – 42 in China and $50 in Tanzania), the Chinese reported a willingness to pay $55 for cataract surgery (with IOL), compared with less than $3 in Tanzania. 4 Granted that purchasing power parity and lifestyle differ in the 2 countries, but another important difference that we think is critical is the people's expectation of the price of surgery—$500 to $600 in China, compared with $0 to $14 in studied regions of Tanzania. Even within Tanzania, the customary price was significantly associated with the amount patients were willing to pay. 4 We see several important implications from these studies: 1. Using VA cutoffs to refer patients for cataract surgery (e.g., referring only those blind or with severe visual impairment) will likely exclude those most willing to accept and pay for surgery. In this case, will lower-level health workers (primary eye care workers) be effective as gatekeepers or case finders for surgical services? 2. Because more people are demanding surgery well before they become blind, the quality of surgery must be high enough to ensure improved vision afterward. 3. Finally, although segments of the population are too poor to pay for surgery, we agree with He et al that offering free or very low cost surgery universally may undermine willingness to …
منابع مشابه
Investigation of visual acuity and residual refractive error after cataract surgery in patients with senile cataract by phacoemulsification
Background and Aim: Vision improvement and reduction of refractive errors are considered as important goals of cataract surgery. The purpose of this study was to evaluate residual refractive errors after cataract surgery in the patients with senile cataract in Shahid Rahimi Hospital in Khorramabad City between 2017 and 2018. Material and Methods: This cross-sectional study included 178 patients...
متن کاملAbdominal Pain after Cataract Surgery with Remifentanil Based Anesthesia
Remifentanil is an ultra short acting opioid that is suitable for many operations and is wildly used for induction and maintenance of anesthesia. In this article we have reported the incidence of abdominal pain after cataract surgery in patients with remifentanil based anesthesia. This study is a randomized single blind clinical trial on 300 patients who were candidates for elective cataract su...
متن کاملAbdominal Pain after Cataract Surgery with Remifentanil Based Anesthesia
Remifentanil is an ultra short acting opioid that is suitable for many operations and is wildly used for induction and maintenance of anesthesia. In this article we have reported the incidence of abdominal pain after cataract surgery in patients with remifentanil based anesthesia. This study is a randomized single blind clinical trial on 300 patients who were candidates for elective cataract su...
متن کاملToward a prospective payment system for ambulatory surgery
In this article, ambulatory surgery among the aged Medicare population in 1985 is examined. Total hospital facility charges for ambulatory surgery in that year were estimated at $1.8 billion, with about one-half of that amount involving cataract surgery. The possibility of using diagnosis-related groups for a prospective payment system for ambulatory surgery was examined and was rejected for tw...
متن کاملAn updated estimate of costs of endophthalmitis following cataract surgery among Medicare patients: 2010–2014
BACKGROUND Endophthalmitis, which can occur after ophthalmic surgery, is an inflammation of the intraocular cavity and causes temporary or permanent vision impairment. However, little is known about the cost of treatment. The objective of this analysis was to update and expand upon the results of a previously published report that estimated the direct medical cost of treatment for endophthalmit...
متن کاملComparative study of preemptive Ketorolac and Tetracaine eye drops on the need for sedatives and analgesics during and after cataract surgery
Introduction: Tetracaine drop is commonly used in ophthalmic surgeries. Ketorolac drop is an anti-inflammatory drug that has been used in some surgical procedures. The present study compared the effect of Ketorolac and Tetracaine eye drops on the need for sedative and analgesic medications during and after cataract surgery. Materials and Methods: In this clinical trial study, 86 patients underg...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Ophthalmology
دوره 115 1 شماره
صفحات -
تاریخ انتشار 2008