Finger Robert P
Department of Ophthalmology, University of Bonn, Germany.
Ophthalmic Epidemiol. 2007 May-Jun;14(3):112-8. doi: 10.1080/09286580601114967.
Blindness, especially related to cataracts, poses a major challenge all over the developing world. India, as one of the biggest developing countries, has a large number of blind requiring sight-restoring cataract surgery. Despite the increase in service availability and heightened outreach screening efforts, blindness has not decreased and uptake of offered cataract surgery services is suboptimal.
Barriers to access cataract surgery services in India have been investigated in several studies, which were reviewed after having been identified through a Medline and Pubmed search and summarized by using a model of health care utilization.
Numerous barriers, such as financial reasons, distance, fear, lack of service awareness, lack of support, or other obligations, could be identified but have not been put into the wider context of health care utilization behavior. Financial barriers continue to be a major reason not to take up offered cataract surgery services.
More in-depth research of underlying factors is needed to increase self-motivated uptake of offered cataract surgery services. This would free resources currently invested into patient recruitment such as outreach screening. Freed resources could then be invested into treatment and further interventions such as health literacy promotion.
失明，尤其是与白内障相关的失明，在整个发展中世界构成了一项重大挑战。印度作为最大的发展中国家之一，有大量盲人需要接受恢复视力的白内障手术。尽管服务可及性有所提高，外展筛查工作也得到加强，但失明情况并未减少，所提供的白内障手术服务的接受率也不理想。
印度获取白内障手术服务的障碍已在多项研究中得到调查，这些研究是通过对Medline和Pubmed进行检索后确定的，并采用医疗保健利用模型进行了总结。
可以确定众多障碍，如经济原因、距离、恐惧、缺乏服务意识、缺乏支持或其他义务，但这些障碍尚未被置于医疗保健利用行为的更广泛背景中。经济障碍仍然是不接受所提供的白内障手术服务的主要原因。
需要对潜在因素进行更深入的研究，以提高对所提供的白内障手术服务的自主接受率。这将释放目前投入到患者招募（如外展筛查）中的资源。然后，释放出的资源可投入到治疗以及诸如促进健康素养等进一步干预措施中。
