Application of Andersen–Newman model to assess cataract surgery uptake among older Australian women: findings from the Australian Longitudinal Study on Women’s Health (ALSWH)

Abstract

Introduction Although Cataract Surgery Rate is increasing, the availability of surgery is outstripped by the increasing number of cataract cases as populations age. Aim The study aimed to identify factors associated with cataract surgery uptake in terms of predisposing, enabling, and need factors in very old Australian women. Method This study used ALSWH data included 6229 women aged 79–84 to 85–90 years. Women were asked whether they had undergone eye surgery (including cataracts) three years prior to each survey. Generalised estimating equation modelling was used to determine factors associated with these surgeries. Result At baseline (2005), more than half of the participants either had undergone surgery (43.5%) or had unoperated cataracts (7.6%). Increasing age (AOR = 1.11, 95% CI = 1.07, 1.15) and being current or ex-smokers (AOR = 1.15, 95% CI = 1.03, 1.29) were associated with higher odds of cataract surgery (predisposing factors). Women who had private health insurance had 27% higher odds of having surgery (AOR = 1.27, 95% CI = 1.16, 1.39) (enabling factor). Need factors of more General Practitioner visits (AOR = 1.16, 95% CI = 1.09, 1.25) and skin cancer (AOR = 1.09, 95% CI = 1.01, 1.17) also increased the odds of cataract surgery. Women who had no difficulty seeing newspaper print were more likely to have had cataract surgery (AOR = 1.35, 95% CI = 1.23, 1.48). Conclusion Need factors are the major drivers of cataract surgery; however, predisposing and enabling factors also play a role, including access to private health insurance. This finding indicates some inequity regarding access to cataract surgery in the Australian setting.

Association between health insurance membership and cataract surgery utilization: A systematic review and meta-analysis

“…Finally, seven articles were included in the meta-analysis. [12][13][14][15][16][17][18] Table 1 provides an overview of the characteristics of the studies included in this systematic review, such as the first author's name, country, published year, study design, sample size, P-value, and OR. A total of seven articles were identified from several countries including Ghana, Australia, China, Germany, India, and England.…”

“…[26] Insurance coverage exhibits a strong correlation with enhanced health-care accessibility and superior health outcomes, enabling individuals with private health insurance to access the services of their preferred surgeons and expedite the surgical process. [13] A study conducted by reported that financial impediments encompass more than mere health insurance aspects, encompassing transportation expenses and government policies about health insurance reimbursement for cataract surgery. These multifaceted factors exert a pronounced influence on the augmentation of cataract surgery rates.…”