Xu Yi, He Jiangnan, Lin Senlin, Zhang Bo, Zhu Jianfeng, Resnikoff Serge, Lu Lina, Zou Haidong
Shanghai Eye Disease Prevention & Treatment Center / Shanghai Eye Hospital; Shanghai Key Laboratory of Ocular Fundus Diseases; Shanghai General Hospital; Shanghai Engineering Center for Visual Science and Photomedicine, 380 Kangding Road, Shanghai, 200040, China.
Brien Holden Vision Institute and SOVS, University of New South Wales, Sydney, NSW, Australia.
BMC Ophthalmol. 2018 Apr 18;18(1):102. doi: 10.1186/s12886-018-0767-5.
It was reported that lack of knowledge, less confidence of medical services, commute difficulties, and poor economic conditions would be the main barriers for cataract surgery practice. The influencing factors could have changed in cities with high developing speed. Shanghai is one of the biggest cities in China and the world. The purpose of the study was to explore the factors influencing cataract surgery practice in Shanghai.
This was a population-based, cross-sectional study. A total of 2342 cataract patients older than 50 years old with cataract-induced visual impairment or who had undergone cataract surgery were recruited from rural and urban areas of Shanghai. Participants accepted a face-to-face structured questionnaire. Data were collected on patient demographics, education, work, income, health insurance, awareness about cataracts disease, treatment and related medical resources and deration policy, transportation and degree of satisfaction with hospitals.
There were 417 patients who had received cataract surgery, 404 of them supplied complete information in the questionnaire. More female subjects (64.6%) than male subjects (35.4%) accepted cataract surgery among the 404 patients. Of the patients with cataract history, 36.4% of surgery patients were equal or older than 80. More people with urban medical insurance received surgery (p = 0.036). Patients who received surgery were more satisfied with local medical service (p = 0.032). In urban area, Lower income and difficulties with commutes were related to a higher rate of surgery.
Cataract patients with the following features were more inclined to receive surgery: female, old age, better awareness. In urban areas low income and difficult commutes did not represent barriers for cataract surgery, probably because of appropriate cataract surgery promotion policies recent years in Shanghai. In rural areas, better healthcare reimbursement policies would likely lead to a higher uptake of cataract surgery. Further cohort studies with more controls could supply stronger evidence for our viewpoint.
据报道，知识匮乏、对医疗服务信心不足、交通不便以及经济条件差是白内障手术实施的主要障碍。在发展速度较快的城市，这些影响因素可能已经发生了变化。上海是中国乃至世界最大的城市之一。本研究的目的是探讨影响上海白内障手术实施的因素。
这是一项基于人群的横断面研究。从上海农村和城市地区招募了2342名年龄在50岁以上、因白内障导致视力障碍或已接受白内障手术的患者。参与者接受了面对面的结构化问卷调查。收集了患者的人口统计学信息、教育程度、工作、收入、医疗保险、对白内障疾病的认知、治疗及相关医疗资源和医保政策、交通情况以及对医院的满意度等数据。
有417名患者接受了白内障手术，其中404名在问卷中提供了完整信息。在这404名患者中，接受白内障手术的女性受试者（64.6%）多于男性受试者（35.4%）。在有白内障病史的患者中，36.4%的手术患者年龄等于或超过80岁。更多参加城镇医疗保险的患者接受了手术（p = 0.036）。接受手术的患者对当地医疗服务更满意（p = 0.032）。在城市地区，低收入和交通困难与更高的手术率相关。
具有以下特征的白内障患者更倾向于接受手术：女性、年龄较大、认知较好。在城市地区，低收入和交通困难并非白内障手术的障碍，这可能是由于近年来上海实施了适当的白内障手术推广政策。在农村地区，更好的医疗报销政策可能会导致白内障手术的更高接受率。进一步的队列研究以及更多的对照可以为我们的观点提供更有力的证据。
