title: Sources of patient knowledge and financing of cataract surgery in rural China: the Sanrao Study of Cataract Outcomes and Up-Take of Services (SCOUTS), report 6.
abstract: OBJECTIVE
  To study patient sources of knowledge about cataract surgical services, and strategies for financing surgery in rural China.
  
  
  METHODS
  Cross-sectional case series.
  
  
  METHODS
  Patients undergoing cataract surgery by local surgeons in a government, village-level facility in Sanrao, Guangdong between 8 August and 31 December 2005 were examined and had standardised interviews an average of 12 months after surgery.
  
  
  RESULTS
  Of 313 eligible patients, 239 (76%) completed the questionnaire. Subjects had a mean (SD) age of 69.9 (10.2) years, 36.4% (87/239) were male, and 87.0% (208/239) had been blind (presenting visual acuity < or = 6/60) before surgery. Word-of-mouth advertising was particularly important: 198 (85.0%) of the subjects knew a person who had undergone cataract surgery, of whom 191 (96.5%) had had cataract surgery at Sanrao itself. Over 70% of subjects (166/239) watched TV daily, whereas 80.0% (188/239) "never" read the newspaper. Nearly two-thirds of suggestions from participants (n = 211, 59.6%) favoured either TV advertisements or word-of-mouth to publicise the programme. While the son or daughter had paid for surgery in over 70% of cases (164/233), the patient's having paid without help was the sole predictor of undergoing second-eye surgery (OR 2.27 (95% CI 1.01 to 5.0, p = 0.04)).
  
  
  CONCLUSIONS
  Strategies to increase uptake of cataract surgery in rural China may benefit from enhancing word-of-mouth advertising (such as with pseudophakic motivators), using television advertising where affordable, and micro-credit or other programmes to enable patients to pay their own fees, thus increasing uptake of second-eye surgery.
authors.affiliation: Joint Shantou International Eye Center, Shantou University, Shantou, Guangdong, PRC. ncongdon@cuhk.edu.hk
authors.forename: N
authors.initials: N
authors.lastname: Congdon
authors.forename: S K
authors.initials: SK
authors.lastname: Rao
authors.forename: K
authors.initials: K
authors.lastname: Choi
authors.forename: W
authors.initials: W
authors.lastname: Wang
authors.forename: S
authors.initials: S
authors.lastname: Lin
authors.forename: S
authors.initials: S
authors.lastname: Chen
authors.forename: L J
authors.initials: LJ
authors.lastname: Chen
authors.forename: K
authors.initials: K
authors.lastname: Liu
authors.forename: I C
authors.initials: IC
authors.lastname: Hu
authors.forename: D S C
authors.initials: DS
authors.lastname: Lam
mesh_terms: D000368:Aged; D002386:Cataract / Q000503:physiopathology; D002387:Cataract Extraction / Q000191:economics*; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D005102:Health Expenditures; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic / Q000379:methods*; D012086:Reoperation; D012424:Rural Population; D016896:Treatment Outcome; D014792:Visual Acuity