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

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.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%.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.Cataract is a leading cause of blindness around the world. Approximately 18 million people worldwide are blind from bilateral mature cataracts[1]. In developing countries 50-90% of all blindness cases are caused by cataracts. As the world's largest developing country, China is a country with nearly 1.4 billion population, among which there are 2.5 million cataracts with an annual increase of 400 thousand patients[2]. Removing the cataract surgically and replacing the natural lens with a synthetic intraocular lens (IOL) remain the only effective treatment for cataracts. The c