Dr Emmy Y. LI, MRCSDr Chung Chai CHI, FRCSProf. Dennis S. LAM, MD

Dept. of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong

The authors have no financial interest in the subject matter of this poster

Background Cataract accounts for 48% of all global blindness, affecting over 18

million people worldwide

The enormous burden of cataract blindness is not due to lack of efficacious treatment. In fact, cataract surgery is one of the most cost-effective interventions in the field of health care

Instead, cataract blindness results from the sizable gap in health care delivery between affluent and poor societies

Barriers to uptake of cataract surgery in developing countries include

！ a significant shortage of ophthalmologists ！ a lack of awareness about cataract and its treatment ！ a lack of trust in quality of locally available services！ direct and indirect costs arising from surgery！problems with transportation

BackgroundCataract surgical rates (CSR) reported by WHO in 2006 revealed

considerable variation among countries with apparently similar level of

economic development

Purpose

1. To assess the correlation between CSR and economic development, selected social and public health indices

2. To identify possible determinants of CSR at a macro level

Methods

This is an ecological study of 101 countries in five continents with different levels of economic development, socio-demographic characteristics and healthcare systems

Methods CSR defined as the number of

cataract operations performed per million population within 1 calendar year were obtained from WHO website and OECD Health Data

GDP per capita and selected social and public health indices were collected from the CIA website

Methods

Correlation between CSR and GDP per capita, urbanization, Gini coefficient (a measure of income inequality), illiteracy rate, labor force in agriculture, infant mortality rate (IMR) and life expectancy at birth were studied using the non-parametric test via Spearman’s rho

ResultsCorrelation with

Cataract Surgical RatesSpearman’s rho

correlation coefficient

Economic Development

GDP per capita + 0.83

Social Development Indices

Labor force in agriculture - 0.80

Illiteracy rate - 0.70

Population below poverty line - 0.70

Gini coefficient - 0.52

Unemployment rate - 0.34

Urbanization + 0.66

Public Health Indices

Infant mortality rate - 0.86

Life expectancy at birth + 0.85

All with p values <0.01

Scatter Plot showing relationships between CSR and GDP per capita

India is doing exceptionally good compared to its counterparts with similar level of GDP

Scatter Plots showing relationships between CSR and IMR & Life expectancy

CSR in general correlated well with IMR and life expectancy, but at extreme ends of the scale, there might still be a wide variation of CSR in countries with similar level of performance

By Univariate Analysis of Variance, interaction effect was found between GDP per capita and Gini coefficient, unemployment rate, urbanization and life expectancy at birth.

Meaning these parameters were inter-related to one another in the development of a country

Results

Conclusion The level of GDP per capita is highly

predictive of CSR in a country Countries with majority of its population

being farmers, illiterate, living in rural areas and in poverty tend to have low CSR

High IMR and short life expectancy suggestive of suboptimal healthcare provision are associated with a low CSR.