PMID- 28249047
OWN - NLM
STAT- MEDLINE
DCOM- 20170817
LR  - 20220330
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 3
DP  - 2017
TI  - Effective cataract surgical coverage: An indicator for measuring quality-of-care 
      in the context of Universal Health Coverage.
PG  - e0172342
LID - 10.1371/journal.pone.0172342 [doi]
LID - e0172342
AB  - 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.
FAU - Ramke, Jacqueline
AU  - Ramke J
AUID- ORCID: 0000-0002-5764-1306
AD  - School of Social Sciences, Faculty of Arts and Social Sciences, University of New 
      South Wales, Sydney, New South Wales, Australia.
AD  - School of Population Health, University of Auckland, Auckland, New Zealand.
FAU - Gilbert, Clare E
AU  - Gilbert CE
AD  - Department Clinical Research, Faculty Infectious & Tropical Diseases, London 
      School of Hygiene and Tropical Medicine, London, United Kingdom.
FAU - Lee, Arier C
AU  - Lee AC
AD  - School of Population Health, University of Auckland, Auckland, New Zealand.
FAU - Ackland, Peter
AU  - Ackland P
AD  - International Agency for the Prevention of Blindness, London, United Kingdom.
FAU - Limburg, Hans
AU  - Limburg H
AD  - Health Information Services, Nijenburg 32, Grootebroek, Netherlands.
FAU - Foster, Allen
AU  - Foster A
AD  - Department Clinical Research, Faculty Infectious & Tropical Diseases, London 
      School of Hygiene and Tropical Medicine, London, United Kingdom.
LA  - eng
PT  - Journal Article
DEP - 20170301
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Aged
MH  - Cataract/*economics
MH  - *Cataract Extraction/economics/ethics
MH  - *Databases, Factual
MH  - Female
MH  - *Healthcare Disparities/economics/ethics
MH  - Humans
MH  - *Insurance Coverage/economics/ethics
MH  - Male
MH  - Middle Aged
MH  - *Quality of Health Care/economics/ethics
MH  - Sex Factors
PMC - PMC5382971
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2017/03/02 06:00
MHDA- 2017/08/18 06:00
PMCR- 2017/03/01
CRDT- 2017/03/02 06:00
PHST- 2016/10/16 00:00 [received]
PHST- 2017/02/03 00:00 [accepted]
PHST- 2017/03/02 06:00 [entrez]
PHST- 2017/03/02 06:00 [pubmed]
PHST- 2017/08/18 06:00 [medline]
PHST- 2017/03/01 00:00 [pmc-release]
AID - PONE-D-16-41221 [pii]
AID - 10.1371/journal.pone.0172342 [doi]
PST - epublish
SO  - PLoS One. 2017 Mar 1;12(3):e0172342. doi: 10.1371/journal.pone.0172342. 
      eCollection 2017.