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Open Access Research article

Variation of cataract surgery costs in four different graded providers of China

Jiahua Fang1*, Xinghua Wang2, Zhende Lin3, Jihua Yan4, Ye Yang3 and Jingbo Li1

Author Affiliations

1 Department of Ophthalmology, First Hospital of Jingzhou, Yangtze University, Jingzhou 434000, China

2 Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China

3 State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou 510060, China

4 Jingshan County Hospital, Jingshan 431800, Hubei Province, China

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BMC Public Health 2010, 10:543  doi:10.1186/1471-2458-10-543

Published: 9 September 2010

Abstract

Background

China has the largest population of cataract patients in the world. However, the cataract surgery rate per million remains low in China. We carried out a survey on costs of cataract surgery from four different graded providers in China and analyzed differences in cost among these clinics.

Methods

1,189 patients were recruited for the study in four eye clinics, located in two provinces, Guangdong province in southern China and Hubei province in central China. The average cost of each cataract surgery episode was calculated including cost of intraocular lens, cost of drugs and facility cost. We also collected information on reimbursement and disposable annual income of local residents.

Results

Mean total cost per cataract intervention of four different providers varied considerably, ranging from US$ 1,293 in Union Hospital to US$ 536 in Jingshan County Hospital. In all providers, except for Jingshan County Hospital, the cost exceeded annual disposable income of local rural residents. As to the proportion of patients with reimbursement, the figure for Union Hospital was only 36%, while for other three clinics it was more than 60%. There was a significant difference between mean reimbursement ratios, with the highest ratio in Zhongshan Ophthalmic Center being 71%.

Conclusions

Significant differences in costs of cataract surgery were found among the 4 different graded providers. A part of the cost was borne by patients. Proportion of patients with reimbursement and mean reimbursement ratios were higher in economically developed regions than in economically developing regions. Much more financial support should be directed into the rural New Cooperative Medical Scheme to raise the reimbursement ratio in rural China.