Bridging Patient and Provider Perspectives in Eye-Care Utilisation: An Integrated Analysis of Psychosocial Determinants and System Barriers in Jharkhand
Debanjali Bhattacharjee, Ankit S. Varshney, Jyoti SinhaAbstract
Background:
Visual impairment remains a major public health challenge, particularly in low- and middle-income countries where gaps persist in both care-seeking behaviour and service delivery. Patient-level psychosocial determinants and provider-level operational barriers are often studied separately, limiting comprehensive understanding.
Objective:
To evaluate patient- and provider-level factors relevant to eye-care access, service experience, and comprehensive eye-screening implementation by integrating patient-reported psychosocial and service-related factors with provider-reported practices and operational barriers.
Methods:
This cross-sectional study integrated two complementary datasets collected in Jharkhand. The patient component included 403 adult eye-care receivers and assessed emotional burden, social barriers, service satisfaction, and technology openness using a structured instrument supported by classical test theory and Rasch modelling. The provider component included 61 eye-care professionals and evaluated attitudes, practice implementation, and operational barriers in comprehensive eye screening. Analyses included descriptive statistics, reliability testing, correlation, subgroup comparisons, multivariable regression, interaction modelling, and effect-size estimation with False Discovery Rate correction.
Results:
Mean standardised scores were 60.83 ± 16.87 for Emotional Burden, 49.35 ± 12.85 for Social Barriers, 54.39 ± 20.01 for Service Satisfaction, and 75.88 ± 26.43 for Technology Openness. The Emotional Burden domain showed poor internal consistency (Cronbach’s α =0.28), and related findings should therefore be interpreted cautiously. Social Barriers were associated with Emotional Burden (β =0.38,
Conclusion:
Patient- and provider-level findings identified psychosocial, service-related, and operational factors relevant to eye-care delivery. Strengthening follow-up systems, provider support, and technology-enabled coordination may improve continuity of care; however, causal relationships and the relative contribution of patient- versus system-level factors cannot be established from this cross-sectional study.