Résumé :
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[BDSP. Notice produite par INIST R0xwn3hN. Diffusion soumise à autorisation]. Background In India 3.8 million people become blind due to cataracts every year. We assessed the cost-effectiveness of public-funded options for delivering cataract surgery in Mysore, Karnataka State, India. Methods Three types of delivery of cataract surgery were studied : mobile government camps, walk-in services at a state medical college hospital, and patients transported in from satellite clinics to a non-governmental hospital. We assessed outcomes in a systematic sample of patients operated on in 1996-97 by follow-up at home ; average costs by provider derived from actual expenditures during the year. Findings Almost half the patients operated on in government camps were dissatisfied with the outcome (34/70,49% [95% Cl 36-61]). More than one third were blind in the operated eye (25/70,36% [25-48]). User satisfaction was higher with other providers (medical college hospital 82% [63-94] ; non-government hospital 85% [72-93]), and fewer patients remained blind. Camps were a low-cost option, but the poor outcomes reduced their cost-effectiveness to US$97 per patient. The state medical college hospital was least cost-effective, at US$176 per patient, and the non-governmental hospital was the most cost-effective at US$54 per patient. Interpretation The government of India should review its policy for government camp surgery, and consider alternatives, such as transporting patients to better permanent facilities. (...)
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