Cataract surgery in South West Thames Region: An analysis of age-adjusted surgery rates and length of stay by district

doi:10.1016/S0033-3506(05)80170-2

Public Health

Volume 107, Issue 6, November 1993, Pages 441-449

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Although the frequency of cataract surgery has increased in the UK, the demand is still not being met. There is no evidence of whether Regional Health Authorities are meeting the national target of 150 cataract operations per 100,000 population. This paper describes variations in age-standardised rates of cataract surgery and lengths of hospital stay (LOS) between the 13 health districts in South West Thames Regional Health Authority (SWTRHA). A retrospective analysis of cataract surgery performed on South West Thames (SW Thames) residents during 1990 was undertaken using the Korner hospital activity data system. The residents of SW Thames Region had 6,729 cataract operations in 1990, producing an overall surgery rate of 266 per 100,000 resident population. Two-thirds of the operations were performed on women, and the greatest number of operations were in the 75–79 and 80–84 year age bands. Women aged over 75 had significantly higher age-specific surgery rates than their male counterparts. The mean age for women was 76.6 years and for men 71.9 years; 12% of cases had a length of stay less than a day (day cases) and 49% were discharged within two days. There were substantial variations in LOS between health districts. Age-adjusted rates revealed significant variations between districts, four of which had rates below the regional average.

The crude cataract surgery rate for SW Thames residents has increased threefold since 1975. Women have a significantly higher rate of surgery, which may be due to social factors. Variations in LOS between districts cannot be explained by difference in age structure and may be caused by local custom and practice. It is possible for national, regional and district cataract rates to be calculated, and they are a useful indicator of how the need for cataract surgery is being met in the population.

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Cited by (17)

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2005, Journal of Cataract and Refractive Surgery
Citation Excerpt :
The discrepancy in the proportion of women who had cataract surgery in our study and the proportion in these other studies warrants discussion. The higher relative risk for cataract surgery among women has been recognized for a long time,11–13,16–20 and several possible explanations have been put forth to account for this finding. These include social factors, referral patterns, and the higher prevalence of cataract in women.
To investigate the age and sex profile of patients having cataract surgery by 2 consulting ophthalmic surgeons over an 18-year period.
Waterford Regional Hospital, Waterford, Republic of Ireland.
Operating theater logbooks were reviewed, and all patients having cataract surgery between January 1986 and December 2003 in Waterford Regional Hospital were identified. The following data were recorded for each patient: age, sex, and type of cataract surgery. Patients having cataract surgery were categorized according to the date of the procedure as follows: Group 1: 1986–1991; Group 2: 1992–1997; Group 3: 1998–2003.
Eight thousand two hundred fifty-seven patients who had cataract surgery during the study period were identified. The mean age of patients was 72.32 years ± 12.21 (SD) and 74.89 ± 11.03 years of men and women, respectively. The age profile of patients having cataract surgery was statistically comparable in Groups 1, 2, and 3 (mean age; Group 1: 72.33 ± 13.03 years; Group 2: 73.72 ± 11.78 years; Group 3: 74.57 ± 10.69 years), indicating that the age profile of patients did not change significantly with the passage of time (analysis of variance, F<1). The proportion of women having cataract surgery rose significantly over the duration of the study period (1986–1991: 55.13%; 1992–1997: 57.68%; 1998–2003: 59.43% (chi-square test, P<.01)).
The age profile of 8257 patients having cataract surgery did not change over the 18-year study period. A small but significant increase in the proportion of women having cataract surgery was noted in latter years. This data is useful to those involved in health care planning.
Resource management of cataract patients: Can visual rehabilitation be achieved in three visits?
1996, Journal of Cataract and Refractive Surgery
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Methods: In this pilot study, patients with age-related cataract requiring surgery were prospectively recruited to a standardized management protocol, the three-episode model, with assessment by an independent observer. Main outcome measures were number of postoperative visits, patient satisfaction, and refractive error at 2 and 6 weeks postoperatively.
Results: Almost 90% of patients could be managed within this model of care. Patient satisfaction was high; no patient requested further hospital visits. Mean change in refractive error between 2 and 6 weeks was 0.34 diopters (D), with a modal value of 0 D. Patients were able to obtain spectacles 2 weeks postoperatively because little change in refraction occurs over the next month.
Conclusion: The three-episode model for the management of patients with cataract could result in significant financial savings. Such savings could be used to treat patients with cataract who otherwise would not have treatment or would have their surgery delayed.
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Cataract surgery in South West Thames Region: An analysis of age-adjusted surgery rates and length of stay by district

Lancet

Social Science and Medicine

Increasing frequency of surgery for cataract

Eye

Changing workload in ophthalmology: some observations from routine statistics

British Medical Journal

Ophthalmology in the Oxford Region: analysis of time trends from linked statistics

Eye

The cataract explosion: the changing pattern of diagnoses of patients attending an ophthalmic outpatient department

Eye

Clearing the cataract backlog in a (not so) developing country

Eye

Health Services Development Resources Assumptions and Planning Guidelines 1990/91