Effective cataract surgical coverage: An indicator for measuring quality-of-care in the context of Universal Health Coverage.

Effective cataract surgical coverage: An indicator for measuring quality-of-care in the context of Universal Health Coverage.

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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 Caps calculated.FINDINGS:Datasets from 20 countries were included (2005-2013; 67,337 participants; 5,474 cataract surgeries).Median Passion Flower 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.