title: Compliance with follow-up after cataract surgery in rural China.
abstract: OBJECTIVE
  To evaluate reasons for non-compliance with post-cataract surgical follow-up in rural China, and assess the impact of incentives on improving compliance.
  
  
  METHODS
  Patients having undergone cataract surgery more than 3 months previously at cataract surgery training hospitals in Guangdong were invited by telephone and advertisements to a hospital-based study examination, with compensation for travel costs (US$7). Information on prior post-surgical follow up was collected by questionnaire at the hospital or by telephone. Logistic regression was used to assess predictors of post-operative attendance with or without compensation.
  
  
  RESULTS
  Among 518 eligible patients, 426 (82.2%) underwent interviews and 342 (66.0%) attended the compensated study examination. Ninety nine participants (23.2%) reported previously returning for uncompensated follow-up ≥ 3 months post-operatively, and 225 (52.8%) had returned for any prior post-operative examination. Uncompensated follow-up at ≥ 3 months was associated with higher income (P = 0.037), and recalling instruction by a doctor to follow-up (P = 0.001), while age, gender, travel cost, and post-operative satisfaction and vision were not associated. Younger (P = 0.002) patients and those reporting being instructed to follow up (P = 0.008) were more likely to return for the compensated research examination. Among all interviewed subjects, only 170 (39.9%) reported knowing they were to return to hospital.
  
  
  CONCLUSIONS
  Modest compensation, advertisements and telephone contact can increase medium-term follow-up rates after cataract surgery by three-fold. Better communication of specific targets for follow-up may improve follow-up compliance.
authors.affiliation: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Guofu
authors.initials: G
authors.lastname: Huang
authors.forename: Rita
authors.initials: R
authors.lastname: Crooms
authors.forename: Qianyun
authors.initials: Q
authors.lastname: Chen
authors.forename: Nathan
authors.initials: N
authors.lastname: Congdon
authors.forename: Mingguang
authors.initials: M
authors.lastname: He
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D002387:Cataract Extraction / Q000706:statistics & numerical data*; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011182:Postoperative Care; D012424:Rural Population / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires