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Health care in rural vs urban regions: are there differences in pre-, intra- and postoperative quality of care
Poster Details
First Author: T. Herbst GERMANY
Co Author(s): D. Holland J. Foerster
Abstract Details
Purpose:
The availability of medical care may be restricted in rural areas compared to urban regions. This discrepancy seems to be even more significant for the northern part of Germany due to its geographical facts: only a few cities are surrounded by distinctive rural areas. As a consequence, access to medical care may be limited or even worse in structurally weaker areas compared to urban ones. In order to analyze this hypothesis, we compared pre-, intra and postoperative findings of cataract patients in both areas by using raw data as well as quality measurements.
Setting:
Different variables were used in order to compare both groups. Besides well-known pre- and postoperative findings, further variables like LOCS III grades were analyzed. With regard to quality measurements, “Quality Index Bellevue System” was used, which transfers medical findings into quality scores basing upon the German school grading.
Methods:
Our choice of statistical methods depends on the scale level of analyzed data: For examinations on aggregate levels, we used ANOVA test as well as ordinary t-test. For comparisons of single finding QIBs, we came back to Mann-Whitney-test and Kruskal-Wallis test respectively because of ordinal scale levels. Further possible examinations will be realized by appropriate statistical methods.
Results:
Since data analyses are still in progress, first results of only represent interim results. We found a slight but significant lower mean value in LOCS III grades and in preoperative visual acuity for patients of the urban group compared to the rural group. In contrast, no significant differences were found for postoperative visual acuity and SEQ. Furthermore, mean age was slightly higher for patients established in rural areas. Remaining criteria showed no significant differences.
Conclusions:
Interim results showed several differences which indicate a lower standard of care in rural areas compared to urban regions. A poor access to ophthalmological care seems to be the reason for identified discrepancies.
Financial Disclosure:
None