Abstract
ObjectivesTo assess the effects of different types of cataract surgeries and intraocular lenses on generic as well as vision related quality of life of cataract patients, using EQ-5D and IND-VFQ 33 instruments respectively.MethodsAn observational, longitudinal study of patients undergoing cataract surgery was carried out at three ophthalmology centres. Patients were prospectively admitted for surgery for age-related cataract. Generic quality of life was assessed by using Euroqol’s EQ5D-5L questionnaire and vision related quality of life was assessed by the IND-VFQ-33 questionnaire. Data pertaining to vision function and quality of life were collected pre surgery and 4 weeks after the surgery.ResultsOut of total patients (n = 814) recruited for the study, 517 patients were interviewed for both pre-surgery and post-surgery for EQ5D and 519 patients were interviewed for both pre-surgery and post-surgery for IND VFQ 33 tool. The combined data from all three centres showed that Quality Adjusted Life Year (QALY) gains observed in patients undergoing phacoemulsification with foldable lens implantation (2.25 QALY) were significantly higher (0.57 QALY) as compared to Small Incision Cataract Surgery (SICS) with PMMA lens implantation (1.68 QALY). Highest improvement however, in all three subscales of IND-VFQ-33 tool were clearly observed for SICS with PMMA lens implantation.ConclusionsThe study has elicited the Health related and vision related Quality of Life scores for cataract surgeries and subsequent lens implantation. This study also offers Health State Utility Values along with visual outcomes for different surgical procedures, lenses and for the combination of surgery with lens implantation for cataract procedures providing a useful resource for future economic evaluation studies.
Highlights
This study offers Health State Utility Values along with visual outcomes for different surgical procedures, lenses and for the combination of surgery with lens implantation for cataract procedures providing a useful resource for future economic evaluation studies
Health Technology Assessment in India (HTAIn) has been institutionalised since 2016–17 under Department of Health Research (DHR), Ministry of Health and Family Welfare (MoHFW) by the Government of India to facilitate the process of transparent and evidencebased decision making for better healthcare delivery [1,2,3,4,5]
Post-surgery follow up of patients Out of total patients recruited for the study, overall post-surgical follow up rate was 63.8%, where 517 patients were interviewed for both pre and post-surgery for EQ5D and 519 patients were interviewed for both pre and post-surgery for IND VFQ 33 tool
Summary
Rashtriya Swasthya Bima Yojana (RSBY), launched in 2008, was one of the most significant centrally funded efforts towards providing UHC in India [9]. AB-PMJAY was launched in early 2018, by the Government of India to provide comprehensive cover for primary, secondary, and tertiary care amenable conditions [11, 12]. Cataract procedures were the most commonly claimed packages under RSBY with lot of ambiguities in the packages provided under the scheme. It was an urgent requirement for the policymakers to fix cataract packages to be covered under the new AB-PMJAY scheme
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