Socioeconomic and rural differences for cataract surgery in Western Australia
Article first published online: 5 APR 2006
Clinical & Experimental Ophthalmology
Volume 34, Issue 4, pages 317–323, May 2006
How to Cite
Ng, J. Q., Morlet, N. and Semmens, J. B. (2006), Socioeconomic and rural differences for cataract surgery in Western Australia. Clinical & Experimental Ophthalmology, 34: 317–323. doi: 10.1111/j.1442-9071.2006.01214.x
- Issue published online: 5 APR 2006
- Article first published online: 5 APR 2006
- Received 25 July 2005; accepted 20 November 2005.
- cataract surgery;
- data linkage;
- rural medicine;
Background: To examine the relationship between socioeconomic factors, residential locality and cataract surgery incidence.
Methods: This was a population-based study using the Western Australian Data Linkage System to identify all cataract operations performed in patients aged 50+ years in 1996 and 2001. Patients’ residential addresses at the time of operation were geocoded to census localities. Using census-derived indices, procedures were categorized into socioeconomic groups and residential locations (metropolitan and rural). Poisson regression was used to analyse for differences in procedure rates.
Results: The crude cataract surgery rate in Western Australia increased from 4458 to 6631 procedures per million person-years between 1996 and 2001. Female and older patients underwent more surgery. Metropolitan residents were more likely to undergo surgery compared with rural residents; a difference that increased by 17% between 1996 and 2001 (1996: incidence rate ratio [IRR] 1.07, 95% confidence interval [CI] 1.02–1.13; 2001: IRR 1.24, 95% CI 1.18–1.29). A pronounced ‘U-shaped’ pattern of difference had developed for socioeconomic disadvantage by 2001. The most advantaged underwent 9% more surgery than the most disadvantaged. Rates in the middle two groups were less than the lowest one.
Conclusion: There was growing inequity in the rates of cataract surgery for rural and poorer patients between 1996 and 2001. These differences partly reflect the increasingly two-tiered Australian health system with more privately provided cataract surgery in urban areas.