{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T03:08:17Z","timestamp":1790996897742,"version":"4.1.0"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,9]]},"abstract":"\n Purpose:<\/jats:title>\n Access to eye surgical care in low- and middle-income countries (LMICs) remains limited due to geographical and financial barriers. This survey evaluated the travel and financial burden on patients and caregivers attending perioperative cataract care at an urban base hospital (UBH) versus community clinics (vision centers [VC]) at the Aravind Eye Care System in South India.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n This cross-sectional study surveyed 105 cataract surgery patients divided into three groups based on perioperative appointment location: UBH-only (appointments at UBH), VC-only (appointments at VCs), and UBH\/VC (Day 1 postoperative appointment at VCs, others at UBH). Descriptive statistics and linear regression assessed associations between subgroups and travel and financial burden. The UBH\/VC group reported their preferred location and the reasons.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Over the entire appointment period, transport time for VC-only (353 \u00b1 118 min) was over 3 h lower than UBH-only (589 \u00b1 418 min) and UBH\/VC (568 \u00b1 230 min;\n P<\/jats:italic>\n < 0.001). Total appointment time was lowest for VC-only (562 \u00b1 177; 1069 \u00b1 439 in UBH-only; 1021 \u00b1 383 min in UBH\/VC;\n P<\/jats:italic>\n < 0.001). Compared to UBH-only, the VC-only group had the lowest transport time (\u2212236 min, 95% CI: \u2212371 to \u2212102,\n P<\/jats:italic>\n = 0.001) and total appointment time (\u2212507 min, 95% CI: \u2212673 to \u2212340,\n P<\/jats:italic>\n < 0.001). Transport costs and missed wages were lower for VC-only participants for preoperative and postoperative Day 1 appointments (\n P<\/jats:italic>\n < 0.001). Among UBH\/VC, 63% (n = 22) preferred VC, while 37% (n = 13) preferred UBH.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Decentralized perioperative follow-up care is associated with reduced travel and financial burdens for cataract surgery patients in rural, low-resource settings. Further research is needed to evaluate the clinical effectiveness and operational feasibility of decentralized postoperative care in LMICs.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijo.ijo_2271_24","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T16:02:11Z","timestamp":1756483331000},"page":"1364-1370","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Travel and financial burdens of cataract surgical care in South India: Comparison of postoperative follow-up at local vision centers versus an urban eye hospital"],"prefix":"10.4103","volume":"73","author":[{"given":"In Young","family":"Chung","sequence":"first","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merlin","family":"Benzy","sequence":"additional","affiliation":[{"name":"Cataract and IOL Services, Pondicherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinivasan","family":"Kavitha","sequence":"additional","affiliation":[{"name":"Department of Glaucoma, Aravind Eye Hospital, Pondicherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rengaraj","family":"Venkatesh","sequence":"additional","affiliation":[{"name":"Department of Glaucoma, Aravind Eye Hospital, Pondicherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nakul","family":"Shekhawat","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"key":"R1-20260420","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1001\/jamaophthalmol.2017.5668","article-title":"Association of sex with the global burden of cataract","volume":"136","author":"Lou","year":"2018","journal-title":"JAMA Ophthalmol"},{"key":"R2-20260420","doi-asserted-by":"crossref","first-page":"1310","DOI":"10.18240\/ijo.2021.09.03","article-title":"Socio-economic disparity in visual impairment from cataract","volume":"14","author":"Fang","year":"2021","journal-title":"Int J Ophthalmol"},{"key":"R3-20260420","doi-asserted-by":"crossref","first-page":"5872","DOI":"10.1167\/iovs.16-19894","article-title":"Cataract surgical rate and socioeconomics: A global study","volume":"57","author":"Wang","year":"2016","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"R6-20260420","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1097\/ICU.0b013e3283414fc8","article-title":"The global burden of cataract","volume":"22","author":"Rao","year":"2011","journal-title":"Curr Opin Ophthalmol"},{"key":"R7-20260420","first-page":"4243","article-title":"The association of social determinants of health with cataracts in the U.S.","volume":"63","author":"Ali","year":"2022","journal-title":"Investig Ophthalmol Vis Sci"},{"key":"R8-20260420","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1159\/000055518","article-title":"Epidemiology of cataract in India: Combating plans and strategies","volume":"31","author":"Vajpayee","year":"1999","journal-title":"Ophthalmic Res"},{"key":"R11-20260420","doi-asserted-by":"crossref","first-page":"135","DOI":"10.2471\/BLT.21.286368","article-title":"Access to eye care during the COVID-19 pandemic, India","volume":"100","author":"Muralikrishnan","year":"2022","journal-title":"Bull World Health Organ"},{"key":"R14-20260420","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1111\/tmi.13651","article-title":"What factors affect patients\u2019 ability to access healthcare? An overview of systematic reviews","volume":"26","author":"Dawkins","year":"2021","journal-title":"Trop Med Int Health"},{"key":"R16-20260420","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1136\/bjophthalmol-2011-301378","article-title":"The number of ophthalmologists in practice and training worldwide: A growing gap despite more than 200 000 practitioners","volume":"96","author":"Resnikoff","year":"2012","journal-title":"Br J Ophthalmol"},{"key":"R17-20260420","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.ophtha.2023.09.018","article-title":"Ophthalmology workforce projections in the United States, 2020 to 2035","volume":"131","author":"Berkowitz","year":"2024","journal-title":"Ophthalmology"},{"key":"R18-20260420","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.healthpol.2014.07.018","article-title":"Understanding shortages of sufficient health care in rural areas","volume":"118","author":"Weinhold","year":"2014","journal-title":"Health Policy (New York)"},{"key":"R19-20260420","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1186\/s12889-019-6577-8","article-title":"Transportation barriers to access health care for surgical conditions in Malawi a cross sectional nationwide household survey","volume":"19","author":"Varela","year":"2019","journal-title":"BMC Public Health"},{"key":"R20-20260420","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1007\/s10900-013-9681-1","article-title":"Traveling towards disease: Transportation barriers to health care access","volume":"38","author":"Syed","year":"2013","journal-title":"J Community Health"},{"key":"R21-20260420","doi-asserted-by":"crossref","first-page":"47","DOI":"10.36469\/9825","article-title":"Travel burden and the direct medical costs of urologic surgery","volume":"4","author":"Olson","year":"2016","journal-title":"J Health Econ Outcomes Res"},{"key":"R22-20260420","doi-asserted-by":"crossref","first-page":"2016","DOI":"10.1007\/s11605-017-3537-4","article-title":"The effects of travel burden on outcomes after resection of extrahepatic biliary malignancies: Results from the US extrahepatic biliary consortium","volume":"21","author":"O\u2019Connor","year":"2017","journal-title":"J Gastrointest Surg"},{"key":"R23-20260420","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/S0140-6736(23)01923-2","article-title":"Equity, access, and carbon cost-effectiveness of bilateral cataract surgery","volume":"403","author":"Ting","year":"2024","journal-title":"Lancet"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_2271_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:58:02Z","timestamp":1786647482000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_2271_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,29]]},"references-count":16,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_2271_24","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,29]]},"assertion":[{"value":"2024-09-22","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-01","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}