Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2014

Open Access 01-12-2014 | Research article

Equal access, (Un)equal uptake: a longitudinal study of cataract surgery uptake in older people in England

Authors: Jennifer Whillans, James Nazroo

Published in: BMC Health Services Research | Issue 1/2014

Login to get access

Abstract

Background

Uptake of cataract removal is a function of the effectiveness of the healthcare delivery services: services that are inaccessible, inappropriate, or unaffordable will not be utilised by (sub)populations, who consequently live with untreated cataracts. The aim of the study was to identify the relationship between individual wealth inequalities and uptake of cataract surgery in England, having controlled for the effects of potentially confounding variables.

Methods

The final sample comprised of 2091 respondents from the English Longitudinal Study on Ageing (ELSA) who were diagnosed with cataracts prior to or during the study, aged 50 and over at wave 1, who had not undergone cataract surgery prior to the first survey observation, and had also provided a response in the second wave of the study. The uptake of cataract surgery was measured using the question, have you ever had cataract surgery? Data from waves 1-5 were used to identify those having received treatment during the 8-year observation window of ELSA. Survival analysis techniques were used.

Results

Having controlled for the effects of potentially confounding variables, wealth did not make a statistically significant contribution to the overall fit of the Cox proportional hazard model nor were individual parameters statistically significant. Thus, respondents’ socioeconomic position was not found to be a significant predictor in the uptake of cataract surgery in the UK. Receiving a recommendation from a medical professional was a key driving factors in the uptake of cataract surgery.

Conclusions

Study findings suggest that uptake of cataract surgery among over 50s with a cataracts diagnosis in England do not discriminate on the grounds of individuals’ material social position (wealth).
Appendix
Available only for authorised users
Literature
1.
Asbell P, Dualan I, Mindel J, Brocks D, Ahmad M, Epstein S: Age-related cataract. Lancet. 2005, 365 (9459): 599-609. 10.1016/S0140-6736(05)17911-2.CrossRefPubMed
2.
3.
Lai F, Lok J, Chow P, Young A: Clinical outcomes of cataract surgery in very elderly adults. J Am Geriatr Soc. 2014, 62 (1): 165-170. 10.1111/jgs.12590.CrossRefPubMed
4.
Syam P, Eleftheriadis H, Casswell A, Brittain G, McLeod B, Liu C: Clinical outcome following cataract surgery in very elderly patients. Eye. 2004, 18 (1): 59-62. 10.1038/sj.eye.6700521. 0000CrossRefPubMed
5.
6.
Goddard M, Smith P: Equity of access to health care services: theory and evidence from the UK. Soc Sci Med. 2001, 53 (9): 1149-1162. 10.1016/S0277-9536(00)00415-9.CrossRefPubMed
7.
Dixon A, Le Grand J, Henderson J, Murray R, Poteliakhoff E: Is the British National Health Service equitable? the evidence on socioeconomic differences in utilization. J Health Serv Res Policy. 2007, 12 (2): 104-109. 10.1258/135581907780279549.CrossRefPubMed
8.
van Doorslaer E, Masseria C, Koolman X, Group ftOHER: Inequalities in access to medical care by income in developed countries. Can Med Assoc J. 2006, 174 (2): 177-183. 10.1503/cmaj.050584.CrossRef
9.
Allin S, Masseria C, Mossialos E: Equity in health care use among older people in the UK: an analysis of panel data. Appl Econ. 2010, 43 (18): 2229-2239.CrossRef
10.
Judge A, Welton NJ, Sandhu J, Ben-Shlomo Y: Equity in access to total joint replacement of the hip and knee in England: cross sectional study. BMJ. 2010, 341: c4092-10.1136/bmj.c4092.CrossRefPubMedPubMedCentral
11.
Keenan T, Rosen P, Yeates D, Goldacre M: Time trends and geographical variation in cataract surgery rates in England: study of surgical workload. Br J Ophthalmol. 2007, 91 (7): 901-904. 10.1136/bjo.2006.108977.CrossRefPubMedPubMedCentral
12.
13.
Steptoe A, Breeze E, Banks J, Nazroo J: Cohort profile: the English Longitudinal Study of Ageing (ELSA). Int J Epidemiol. 2013, 42 (6): 1640-1648. 10.1093/ije/dys168. doi:10.1093/ije/dys168CrossRefPubMed
14.
French D, Margo C, Campbell R: Cataract surgery among veterans 65 years of age and older: Analysis of National Veterans Health Administration Databases. Am J Med Qual. 2010, 25 (2): 143-148. 10.1177/1062860609354638.CrossRefPubMed
15.
French D, Browning C, Kendig H, Luszcz M, Saito Y, Sargent-Cox K, Anstey K: A simple measure with complex determinants: investigation of the correlates of self-rated health in older men and women from three continents. BMC Public Health. 2012, 12 (1): 649-10.1186/1471-2458-12-649.CrossRefPubMedPubMedCentral
16.
Grundy E, Sloggett A: Health inequalities in the older population: the role of personal capital, social resources and socio-economic circumstances. Soc Sci Med. 2003, 56 (5): 935-947. 10.1016/S0277-9536(02)00093-X.CrossRefPubMed
17.
Grundy E, Holt G: The socioeconomic status of older adults: how should we measure it in studies of health inequalities?. J Epidemiol Community Health. 2001, 55 (12): 895-904. 10.1136/jech.55.12.895.CrossRefPubMedPubMedCentral
18.
de Oliveira C, Shankar A, Kumari M, Nunn S, Steptoe A: Health Risk and Health Protective Biological Measures in Later Life. Financial Circumstances, Health and Well-Being of the Older Population in England: The 2008 English Longitudinal Study of Ageing (Wave 4). Edited by: Banks J, Lessof C, Nazroo J, Rogers N, Stafford M, Steptoe A. 2010, London: Intitute for Fiscal Studies, 275-347.
19.
Demakakos P, Nazroo J, Breeze E, Marmot M: Socioeconomic status and health: the role of subjective social status. Soc Sci Med. 2008, 67 (2): 330-10.1016/j.socscimed.2008.03.038.CrossRefPubMed
20.
Lewallen S, Mousa A, Bassett K, Courtright P: Cataract surgical coverage remains lower in women. Br J Ophthalmol. 2009, 93 (3): 295-298. 10.1136/bjo.2008.140301.CrossRefPubMed
21.
Boyle S: United Kingdom (England): health system review. Health Syst Transit. 2011, 13 (1): 1.PubMed
22.
Propper C: The demand for private health care in the UK. J Health Econ. 2000, 19 (6): 855-876. 10.1016/S0167-6296(00)00045-X.CrossRefPubMed
23.
Javitt J, Kendix M, Tielsch J, Steinwachs D, Schein O, Kolb M, Steinberg E: Geographic variation in utilization of cataract surgery. Med Care. 1995, 33 (1): 90-105. 10.1097/00005650-199501000-00008.CrossRefPubMed
24.
Goldzweig C, Mittman B, Carter G, Donyo T, Brook R, Lee P, Mangione C: Variations in cataract extraction rates in Medicare prepaid and fee-for-service settings. JAMA. 1997, 277 (22): 1765-1768. 10.1001/jama.1997.03540460029028.CrossRefPubMed
25.
Abraham A, Condon N, Gower E: The new epidemiology of cataract. Ophthalmol Clin North Am. 2006, 19 (4): 415-425.PubMed
26.
Williams A, Sloan FA, Lee PP: Longitudinal rates of cataract surgery. Arch Ophthalmol. 2006, 124 (9): 1308-1314. 10.1001/archopht.124.9.1308.CrossRefPubMed
27.
Black N, Browne J, Van Der Meulen J, Jamieson L, Copley L, Lewsey J: Is there overutilisation of cataract surgery in England?. Br J Ophthalmol. 2009, 93 (1): 13-17. 10.1136/bjo.2007.136150.CrossRefPubMed
28.
Allin S, Grignon M, Le Grand J: Subjective unmet need and utilization of health care services in Canada: what are the equity implications?. Soc Sci Med. 2010, 70 (3): 465-472. 10.1016/j.socscimed.2009.10.027.CrossRefPubMed
29.
Conway L, McLaughlan B: Don’t let age rob you of your sight. Older People and Eye Tests: Campaign Report. 2007, London: RNIB
30.
Metadata
Title
Equal access, (Un)equal uptake: a longitudinal study of cataract surgery uptake in older people in England
Authors
Jennifer Whillans
James Nazroo
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2014
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-14-447

Other articles of this Issue 1/2014

BMC Health Services Research 1/2014 Go to the issue

Research article

How does context influence collaborative decision-making for health services planning, delivery and evaluation?

Research article

Effects of changes in health insurance reimbursement level on outpatient service utilization of rural diabetics: evidence from Jiangsu Province, China

Research article

Self-management support interventions to reduce health care utilisation without compromising outcomes: a systematic review and meta-analysis

Research article

Claims, liabilities, injures and compensation payments of medical malpractice litigation cases in China from 1998 to 2011

Research article

Estimating the incidence of adverse events in Portuguese hospitals: a contribution to improving quality and patient safety

Research article

Patient safety risks associated with telecare: a systematic review and narrative synthesis of the literature