Inequity in Access: Cataract Surgery Throughput of Chinese Ophthalmologists from the China National Eye Care Capacity and Resource Survey

ABSTRACT

Purpose: To investigate the distribution of cataract surgery performed by ophthalmologists in China.

Methods: A cross-sectional study was designed to investigate nationwide ophthalmological resources and capacity for cataract surgery in China⁠—The 2014 China National Eye Care Capacity and Resource Survey. Data analyzed in this report included regional distribution, urban-rural comparison, levels and types of medical institutions, and cataract surgery types and volume per surgeon. In China, only ophthalmologists at or above the level of attending are eligible to perform cataract surgery independently, so the ability of cataract surgery for ophthalmologists at or above the level of attending is analyzed in the current study. Descriptive statistics were used.

Results: 36,333 ophthalmologists were included in this survey, which is an average of 1.33 ophthalmologists to every 50,000 population. Of the surgeons in this survey, 23,412 (50.22%) were attending or more senior ophthalmologists and were mainly distributed in eastern urban areas. Annual average cataract surgeries per ophthalmologist in China were 259 in 2017, less than 300 cases.

Conclusion: The average number of ophthalmologists per population in China has achieved the goal of WHO’s Vision 2020; however, these surgeons are concentrated in urban areas. Further, the ability of cataract surgery among ophthalmologists is unbalanced. The annual average cataract surgeries performed by ophthalmologists are insufficient, which is an important factor resulting in the current situation in China that ophthalmic service capacity has not met the requirements for eliminating cataract blindness.

KEYWORDS:

• Ophthalmology
• human resources
• cataract
• cataract surgical rate
• blindness prevention and treatment

Acknowledgments

We would like to extend our sincere gratitude to all the experts who participated in the design of the 2014 National Eye Resource Survey, to all the institutions and liaisons from 31 provinces (autonomous regions and municipalities directly under the Central Government) and Xinjiang Production and Construction Corps of CPLA that participated in the survey and quality controlling, and to the Orbis International Project for providing the capital support and assistance to this survey. We would also like to thank Prof Lisa Keay and Prof Wang Jie Jin for their helpful comments on the manuscript.

Conflicts of interest

None.

Additional information

Funding

This work was supported by ORBIS International North Asia (Beijing, China) contract no.1541. The sponsor or funding organization had no role in the design or conduct of this research.