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Indication criteria for cataract extraction and gender differences in waiting time
Goldina Smirthwaite1, Mats Lundström, Susanne Albrecht
1Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, SwedenDepartment of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, SwedenDepartment of Clinical Sciences, Ophthalmology, Faculty of Medicine, Lund University, Lund, SwedenEyeNet Sweden, Karlskrona, Sweden.
Acta Ophthalmologica
|August 29, 2013
Summary
The national indication criteria tool for cataract extraction (NIKE) may help reduce gender disparities in cataract surgery waiting times. While women still wait longer, the gap narrowed after NIKE implementation.
Area of Science:
- Ophthalmology
- Health Services Research
- Health Economics
Background:
- Cataract extraction (CE) waiting times can vary significantly.
- Gender disparities in healthcare access and outcomes are a persistent concern.
- Standardized clinical tools may influence patient pathways and reduce inequities.
Purpose of the Study:
- To evaluate the impact of the national indication criteria tool for cataract extraction (NIKE) on gender differences in waiting times for CE.
- To compare waiting times between NIKE-categorized and non-NIKE-categorized patients.
- To analyze gender-based waiting time variations within different indication levels of the NIKE system.
Main Methods:
- Utilized data from The Swedish National Cataract Register (NCR) with 98% coverage.
- Compared gender differences in waiting times for CE for patients categorized by NIKE versus those not categorized.
- Employed logistic regression for multivariate analyses and Student's t-test or chi-square for single variable analyses using SPSS v20.
Main Results:
- Gender, age, visual acuity, and NIKE categorization were significantly associated with waiting time for CE.
- Female patients experienced longer waiting times than male patients, irrespective of NIKE categorization.
- The gender waiting time gap was slightly larger in the non-NIKE-categorized group (0.20 months) compared to the NIKE-categorized group (0.18 months).
Conclusions:
- The introduction of NIKE appears to contribute to a reduction in gender disparities in CE waiting times.
- While gender differences have decreased post-NIKE implementation, the study design could not isolate NIKE's specific effect from other concurrent factors.
- Further research is needed to definitively establish the causal relationship between NIKE and reduced gender-based waiting time inequities.