Do Rates of Cataract Surgery Differ Between Medicare and VHA Patients?

Patients in the Medicare and VHA systems who receive cataract surgery have similar characteristics, according to a population-based retrospective cohort study involving more than 3 million individuals. 

~1.1 million Medicare and ~1.9 million VHA patients who were diagnosed with a cataract between 2002 and 2012 were included. Investigators looked at certain patient characteristics, as well the percentage who had cataract surgery 1 and 5 years after diagnosis. Among the results: 

• 47% of VHA patients were <65.
• 19% of Medicare patients had surgery 1 year after diagnosis, vs 6% of those in the VHA cohort. 
• At 5 years, the percentages of those who had surgery were 36% and 13%, respectively. 
• In both cohorts, patients who were older were more apt to have surgery. 
• More patients in southern vs eastern states were likely to have surgery. 
• Patients with COPD also had increased odds of having their cataracts removed. 
• Female Medicare patients were more likely to have surgery than males.  Those with more comorbidities were more likely to have surgery at 1 year vs the rest of the cohort; this difference was not seen at 5 years. 
• Blacks in both contingents were less likely to have surgery vs their white counterparts.

Wu A, Wu C, Tseng V, et al.  Characteristics associated with receiving cataract surgery in the US Medicare and Veterans Health Administration populations. JAMA Ophthalmol. 2018;136(7):738-745. doi: 10.1001/jamaophthalmol.2018.1361.