Sachin Gupta1, Ravilla D Ravindran2, Ganesh-Babu B Subburaman3, Ashok Vardhan S4, Thulasiraj Ravilla3. 1. Johnson Graduate School of Management, Cornell University, Ithaca, New York, USA. 2. Aravind Eye Hospital, Madurai, India. 3. LAICO, Aravind Eye Care System, India. 4. Aravind Eye Hospital, Tirupati, India. Electronic address: ashokvar@aravind.org.
Abstract
PURPOSE: To identify patient characteristics associated with follow-up compliance and to draw implications for better cataract treatment services. SETTING: Aravind Eye Hospital, Madurai, India. DESIGN: Retrospective case study. METHODS: The data of all cataract surgeries performed in 2015 were analyzed. After each surgery, patients were asked to return for follow-up after 1 month. The follow-up rates were compared between patients with different demographic characteristics, surgical factors, and preoperative and discharge visual acuities. The behaviors of patients who complied with the follow-up advice were analyzed, including the number of days from surgery to follow-up and number of follow-up visits. Multivariate regression models were used to identify predictors associated with these behaviors. RESULTS: The overall follow-up rate for the 86 776 surgeries analyzed was 85.6%. Patients more likely to follow-up were women, younger than 70 years, and paying (versus subsidized or free) and had phacoemulsification rather than manual small-incision cataract surgery (all P < .001). Patients who had complications, reoperations, or poorer visual acuity at discharge were less likely to comply with the follow-up advice (P < .001). CONCLUSIONS: Targeted interventions to boost follow-up rates should be directed to patients with the characteristics found in this study. Furthermore, average measures of visual outcomes at 4 weeks are likely to be overstated relative to the truth.
PURPOSE: To identify patient characteristics associated with follow-up compliance and to draw implications for better cataract treatment services. SETTING: Aravind Eye Hospital, Madurai, India. DESIGN: Retrospective case study. METHODS: The data of all cataract surgeries performed in 2015 were analyzed. After each surgery, patients were asked to return for follow-up after 1 month. The follow-up rates were compared between patients with different demographic characteristics, surgical factors, and preoperative and discharge visual acuities. The behaviors of patients who complied with the follow-up advice were analyzed, including the number of days from surgery to follow-up and number of follow-up visits. Multivariate regression models were used to identify predictors associated with these behaviors. RESULTS: The overall follow-up rate for the 86 776 surgeries analyzed was 85.6%. Patients more likely to follow-up were women, younger than 70 years, and paying (versus subsidized or free) and had phacoemulsification rather than manual small-incision cataract surgery (all P < .001). Patients who had complications, reoperations, or poorer visual acuity at discharge were less likely to comply with the follow-up advice (P < .001). CONCLUSIONS: Targeted interventions to boost follow-up rates should be directed to patients with the characteristics found in this study. Furthermore, average measures of visual outcomes at 4 weeks are likely to be overstated relative to the truth.