Abstract
Background: Access to quality eye care is often unevenly distributed between urban and rural populations, leading to disparities in health outcomes and patient experiences. The purpose of this study was to assess and compare the accessibility, quality, and patient satisfaction with ophthalmologic care at the primary healthcare level between urban and rural populations in East Kazakhstan, and to identify disparities that can inform policy interventions to improve equitable eye care services. Materials and Methods: This cross-sectional study in East Kazakhstan assessed the quality of ophthalmologic care using a structured, reliable questionnaire (Cronbach’s α = 0.940). Data were collected via paper-based surveys in Russian and Kazakh. Total population sampling included adults (≥18) seeking primary eye care. Results: The study revealed significant urban-rural disparities in ophthalmologic care. Rural participants were more often male, less educated, and lower-income, yet reported higher insurance coverage and greater satisfaction with services. However, rural patients faced longer wait times (69.9% vs. 48.3%) and greater scheduling difficulties. Urban patients, while better served in surgical timing and care coordination, more frequently reported not receiving services. Conclusion: This study reveals urban-rural disparities in ophthalmologic care in East Kazakhstan. Rural patients faced longer wait times and coordination issues but reported higher satisfaction. Policy efforts should focus on expanding rural eye care access, enhancing referral systems, enforcing free medication policies, and investing in mobile clinics and tele-ophthalmology to reduce inequities.