Cataract Surgery among Medicare Beneficiaries

Abstract

Purpose: To present descriptive epidemiology of cataract surgery among Medicare recipients in the United States.

Setting: Cataract surgery performed on Medicare beneficiaries in 2003 and 2004.

Methods: Medicare claims data were used to identify all cataract surgery claims for procedures performed in the United States in 2003–2004. Standard assumptions were used to limit the claims to actual cataract surgery procedures performed. Summary statistics were created to determine the number of procedures performed for each outcome of interest: cataract surgery rates by age, sex, race and state; surgical volume by facility type and surgeon characteristics; time interval between first- and second-eye cataract surgery.

Results: The national cataract surgery rate for 2003–2004 was 61.8 per 1000 Medicare beneficiary person-years. The rate was significantly higher for females and for those aged 75–84 years. After adjustment for age and sex, blacks had approximately a 30% lower rate of surgery than whites. While only 5% of cataract surgeons performed more than 500 cataract surgeries annually, these surgeons performed 26% of the total cataract surgeries. Increasing surgical volume was found to be highly correlated with use of ambulatory surgical centers and reduced time interval between first- and second-eye surgery in the same patient.

Conclusions: The epidemiology of cataract surgery in the United States Medicare population documents substantial variation in surgical rates by race, sex, age, and by certain provider characteristics.

KEYWORDS::

• Cataract surgery
• Medicare

ACKNOWLEDGMENTS

This research was funded by grant EY016769-01 from the National Eye Institute, National Institutes of Health. Dr Gower is the recipient of an Ernest and Elizabeth Althouse Special Scholars Award from Research to Prevent Blindness.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.