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傍钵李
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1 An Overview Combating Cataract Wei HE MD, PhD, MBA He University Eye Hospital

2 Cataract: Leading Cause of Blindness Globally

3 Overview CSR of West-Pacific Region(2009) 800 CSR P.R.China Philippines Cambodian Vietnam Laos Australia

4 Overview CSR and Surgery Cases in China Goal by NHFPC:CSR Reach 1300 by Year Cases CSR million million 1067

5 Key Barriers in Combating Cataract in China Low CSR comparing with other countries Although the economic rate in China is rapidly increaseing, CSR still lower than many counties in west-pacific region. Not to mention developed countries (eg. USA, Canada, Japan) CSR>9000, even India CSR>6000. Regional disparity in China In China, CSR differs dramatically among provinces, between west and east China. High cataract surgery expenses in China Imported IOL: good quality but high price, usually between 900-8,000RMB. IOLs made in China: low price but also low rate of usage.

6 Top & Last 5 Provinces of CSR in China,2014 Top 5 Provinces Last 5 Provinces Province (Municipality) Cases CSR Province (Municipality) Cases CSR Shanghai City Beijing City Guizhou Province Guangxi Province Tibet Region Qinghai Province Tianjin City Jilin Province Jiangsu Province Xinjiang Region

7 The most important issue Unbalanced distribution of human resource in ophthalmology According to statistics in 2012, there are 326 eye hospitals in China. 70% of them locate in urban areas working for 49% urban population, while the rest 51% rural population only can be served by 30% eye care hospitals. Cataract operation skills need to be improved There are 31,400 registered ophthalmologists in China, however, each of them only operated 46 cataract cases in 2014.

8 Less information for Indicators for Cataract Surgery CSR (Cataract Surgical Rate):Number of cataract surgeries done per year per 1 million public sector dependent population. CSR is widely used in China by National Health and Family Planning Commission of PRC.(NHFPC) CSC (Cataract Surgical Coverage):CSC is a reliable indicator for availability of health services in many countries, especially to the elderly. Influential new report published in June 2015 co-authored by the WHO and the World Bank identifies a small set of indicators to track and monitor Universal Health Coverage. IAPB s recommendation Cataract Surgical Coverage among the thirteen health intervention indicators listed.iapb strongly recommends CSC data as one viable indicator for health service coverage, as it is supported by data over time and geographies.

9 Current Improvements in Combating Cataract 1. Improve the medical service in primary levels. In September 2015, Chinese government encourage to set up a three-level model in medical care. "Sight First China Action III" program supported by NHFPC, Lions Club, to set up a pilot three-level model for the prevention of blindness in Liaoning province since 2012.

10 Three-Level Model for the Prevention of Blindness

11 Three County-level Hospital Cooperated with He Eye Hospital Zhangwu People's Hospital Shenyang He Eye Hospital Beizhen People's Hospital Haicheng Central Hospital

12 Results: Cataract Surgey Cases Increase

13 取得成效年白内障手术量增长 ( 例 )

14 Tele-medicine Screening: Cost-effective (RMB/Case) Tele-medicine Screening Traditional Screening Medical Equipment and Supplies Human Resource Expenses Costs of Cataract Patient and Accopanied Person Total

15 2. Government keep on encouraging introducing nongovernmental capital into medical industry In 2010, National Development and Reform Commission and Ministry of Health published a document about encourageing nongovernmental capital into medical industry. 83% eye hospitals in China are non-government hospitals. Chinese government orgnize NGO coordinating meetings regualarly to formulate a work pattern of "Leading by the government, participating by all parties".

16 3 HR Provide Training for PBL Team Building National Training Base for the Prevention of Blindness by National Health and Family Planning Commission of PRC in 2012, in He University Eye Hospital. Other training programs conducted by ORBIS International, Fred Hollows Foundation, etc.

18 Team Training for Cataract Problems: No patient No clinical nurse No quality control No staff for measuring IOL Community Eye Health Training Optometry Training Screening Organizor Training Ophthalmic Nursing Training MSICS Surgeon Training

19 Number of Trainees by National Training Base 2014 Training Content Number of Trainee Community Eye Health Training 28,000 MSICS Surgeon Training 100 Ophthalmic Nursing Training 200 Optometry Training 1500 Low Vision Training 300 PBL Program Training 400

20 Quality Control in SICS Surgeon Training

21 4 Conduct national HR investigation and epidemiological investigation in ophthalmology National-wide investigations are under operation by National Health and Family Planning Commission. The NHFPC plans to evaluate opthalmic service in provincial, municipal and county levels in two years.

22 THANKS 辽宁何氏医学院何氏眼科医院地址 : 中国沈阳市黄河北大街 128 号电话 : HE UNIVERSITY EYE HOSPITAL 128, North Huanghe Street, Shenyang, China Tel: 本文件的著作权及版权属沈阳何氏眼科医院, 任何单位及个人, 未经沈阳何氏眼科医院同意及批准, 不得用作商业用途或其他用途 No parts of this document may be reproduced or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission of He Eye Hospital 2013 by He Eye Hospital. All rights reserved.

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