Willingness to Pay for Cataract Surgery in Rural Southern China
Received 17 October 2005; accepted 25 September 2006. published online 02 January 2007.
Purpose
To study willingness to pay for cataract surgery, and its associations, in Southern China.
Design
Cross-sectional willingness-to-pay interview incorporating elements of the open-ended and bidding formats.
Participants
Three-hundred thirty-nine persons presenting for cataract screening in Yangjiang, China, with presenting visual acuity (VA) ≤ 6/60 in either eye due to cataract.
Methods
Subjects underwent measurement of their VA and a willingness-to-pay interview. Age, gender, literacy, education, and annual income also were recorded.
Main Outcome Measures
Maximum amount that the subjects would be willing to pay for cataract surgery.
Results
Among 325 (95.9%) subjects completing the interview, 169 (52.0%) were 70 years or older, 213 (65.5%) were women, and 217 (66.8%) had an annual income of <5000 renminbi (5000 = US $625). Eighty percent (n = 257) of participants were willing to pay something for surgery (mean, 442±444 renminbi [US $55±55]). In regression models, older subjects were willing to pay less (8 renminbi [US $1] per year of age; P = 0.01). Blind subjects were significantly more likely (odds ratio, 5.7; 95% confidence interval, 1.7–19.3) to pay anything for surgery, but would pay on average 255 renminbi (US $32) less (P = 0.004). Persons at the highest annual income level (>10 000 renminbi [US $1250]) would pay $50 more for surgery than those at the lowest level (<5000 renminbi) (P = 0.0003). The current cost of surgery in this program is 500 renminbi (US $63).
Conclusions
Sustainable programs will need to attract younger, more well-to-do persons with better vision, while still providing access to the neediest patients.
3Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
4Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
5Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
Correspondence and reprint requests to Nathan Congdon, MD, MPH, Department of Ophthalmology and Visual Science, Chinese University of Hong Kong, Hong Kong Eye Hospital 3/F, 147K Argyle Street, Kowloon, Hong Kong, China.
Manuscript no. 2005-997.
The work was supported by funds from the Starr Foundation, New York, New York, in support of Helen Keller International.
The authors have no financial interest in the devices or techniques presented in the article.
ABSTRACT