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Geographic variation in utilization of cataract surgery
J C Javitt1, M Kendix, J M Tielsch
1Worthen Center for Eye Care Research, Department of Ophthalmology, Georgetown University Medical Center, Washington, DC 20007.
Medical Care
|January 1, 1995
Summary
Factors like female gender, southern latitude, and higher optometrist supply are linked to increased cataract surgery rates in Medicare beneficiaries. Age, race, and income also influence individual likelihood, while ophthalmologist supply showed no significant association.
Area of Science:
- Ophthalmology
- Health Services Research
- Public Health
Background:
- Cataract surgery is the most common procedure for Medicare beneficiaries, costing over $3.4 billion annually.
- Understanding factors influencing surgery rates is crucial for resource allocation and patient access.
Purpose of the Study:
- To assess demographic, environmental, and provider-related factors associated with cataract surgery likelihood in Medicare beneficiaries.
- To examine geographic variations in cataract surgery rates and influencing factors.
Main Methods:
- Cross-sectional, population-based study using administrative data from a 5% sample of Medicare beneficiaries (1986-1987).
- Employed regional least-squares regression and person-based logistic regression models.
- Analyzed patient age, sex, race, income, latitude, and supply of ophthalmologists/optometrists.
Main Results:
- Higher cataract surgery rates and individual likelihood were associated with female gender, southern latitude, higher optometrist concentration, and higher allowed charges.
- Increased likelihood was also linked to older age (65-94), white race, and higher income areas (>$15,000).
- No significant association was found between ophthalmologist supply and cataract surgery rates or likelihood.
Conclusions:
- Demographic and provider factors, particularly optometrist supply and geographic location, significantly influence cataract surgery rates among Medicare beneficiaries.
- While some factors show association, geographic variation in cataract surgery provision is relatively low compared to other surgical procedures.
- Further research may explore the interplay of these factors to optimize surgical access and outcomes.
