Willingness to pay for cataract surgery in rural Southern China

Ophthalmology. 2007 Mar;114(3):411-6. doi: 10.1016/j.ophtha.2006.09.012. Epub 2007 Jan 2.


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) < or = 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 dollars). Eighty percent (n = 257) of participants were willing to pay something for surgery (mean, 442+/-444 renminbi [US 55 dollars+/-55]). In regression models, older subjects were willing to pay less (8 renminbi [US 1 dollar] 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 dollars) less (P = 0.004). Persons at the highest annual income level (>10,000 renminbi [US 1250 dollars]) would pay 50 dollars 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 dollars).

Conclusions: Sustainable programs will need to attract younger, more well-to-do persons with better vision, while still providing access to the neediest patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cataract / physiopathology
  • Cataract Extraction / economics*
  • China
  • Cross-Sectional Studies
  • Female
  • Health Care Costs*
  • Health Services Needs and Demand / economics*
  • Humans
  • Interviews as Topic
  • Linear Models
  • Male
  • Middle Aged
  • Surveys and Questionnaires
  • Visual Acuity