Is the cost the primary barrier for cataract surgery in Paraguay?

PURPOSE: To determine if the cost was the main barrier to undergo cataract surgery in Paraguay. METHODS: We conducted a cohort study with patients screened in the 2011 Rapid Assessment of Avoidable Blindness (RAAB) who had reported that the cost was the main barrier to undergo cataract surgery in Paraguay. All patients with operable cataract from the RAAB study and with registered telephone numbers were interviewed by telephone and were offered free surgery services. The patients who did not come for surgery were re-interviewed by telephone to analyze the reasons for not undergoing the operation. RESULTS: Out of 122 patients identified in the RAAB study with barriers for cataract surgery, 69 (56.6%) reported that the surgical fee was the main barrier; 52 (75.4%) of them had their telephone numbers registered. Thirty-six (69.2%) patients did not reside in the metropolitan area of Asunción. Six patients (12%), all from Asunción, agreed to undergo free surgery. Forty-six patients did not agree the free surgery mainly due to the costs associated with their transportation (n=31, 67%) and the travel costs of their companion (n=6, 13%). CONCLUSION: Surgery fee alone was not the major contributing factor for not undergoing cataract surgery. Place of residence and other indirect out-of-pocket expenses, such as transportation and companion-related costs appear to be more relevant. While further investigation is needed to assess if reducing the cost of transport will improve the uptake, the findings in this study suggest that a surgical package with all costs should be offered to patients of cataract surgical programs to increase cataract surgical coverage in Paraguay.

Is the cost the primary barrier for cataract surgery in Paraguay? / A taxa para a cirurgia é a principal barreira para a adesão à cirurgia de catarata no Paraguai?

Purpose: To determine if the cost was the main barrier to undergo cataract surgery in Paraguay. Methods: We conducted a cohort study with patients screened in the 2011 Rapid Assessment of Avoidable Blindness (RAAB) who had reported that the cost was the main barrier to undergo cataract surgery in Paraguay. All patients with operable cataract from the RAAB study and with registered telephone numbers were interviewed by telephone and were offered free surgery services. The patients who did not come for surgery were re-interviewed by telephone to analyze the reasons for not undergoing the operation. Results: Out of 122 patients identified in the RAAB study with barriers for cataract surgery, 69 (56.6%) reported that the surgical fee was the main barrier; 52 (75.4%) of them had their telephone numbers registered. Thirty-six (69.2%) patients did not reside in the metropolitan area of Asunción. Six patients (12%), all from Asunción, agreed to undergo free surgery. Forty-six patients did not agree the free surgery mainly due to the costs associated with their transportation (n=31, 67%) and the travel costs of their companion (n=6, 13%). Conclusion: Surgery fee alone was not the major contributing factor for not undergoing cataract surgery. Place of residence and other indirect out-of-pocket expenses, such as transportation and companion-related costs appear to be more relevant. While further investigation is needed to assess if reducing the cost of transport will improve the uptake, the findings in this study suggest that a surgical package with all costs should be offered to patients of cataract surgical programs to increase cataract surgical coverage in Paraguay. .

Objetivo: Determinar se a taxa de cirurgia é a principal barreira para a adesão à cirurgia de catarata no Paraguai. Métodos: Foi realizado um estudo de coorte com pacientes identificados na Avaliação Rápida da Cegueira Evitável (RAAB) de 2011, que haviam informado ser a taxa para a cirurgia a principal barreira para se submeter à cirurgia de catarata no Paraguai. Todos os pacientes com catarata operável a partir do estudo RAAB, cujos números de telefone foram registrados, foram entrevistados por telefone e foi oferecida a cirurgia gratuitamente. Aqueles pacientes que não compareceram para a cirurgia foram então re-entrevistados por telefone para confirmar as suas razões para não fazer a cirurgia. Resultados: Das 122 pessoas identificadas no estudo RAAB com barreiras para a cirurgia de catarata, 69 (56,6%) relataram a taxa cirúrgica como a principal barreira para a cirurgia; 52 (75,4%) destes indivíduos tiveram seus números de telefone registrados. Trinta e seis (69,2%) pacientes não residiam na área metropolitana de Assunção. Seis pacientes (12%) aceitaram se submeter à cirurgia gratuita, todos eles de Assunção. Dos 46 pacientes que não aceitaram a cirurgia gratuita, as duas principais razões para o não comparecimento foi o custo de transporte (n=31, 67%) e os custos de viagem de seu companheiro (n=6, 13%). Conclusão: A taxa de cirurgia de catarata per se não foi a barreira principal. Local de residência e outras despesas pessoais indiretas, como transporte e custos relacionados à companhia parecem ser mais relevantes. Embora mais estudos sejam necessários para avaliar se a redução do custo do transporte vai melhorar a adesão, os resultados sugerem que um pacote cirúrgico que inclua todos os custos deve ser oferecido aos pacientes dos programas de ...