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Abstract
BackgroundUptake 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.MethodsThe 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.ResultsHaving 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.ConclusionsStudy 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).
Highlights
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 bypopulations, who live with untreated cataracts
Where cataract surgery uptake is the specific focus of enquiry, Kennan et al have argued that the rate of cataract surgery by local authority showed a positive correlation with the index of multiple deprivation (IMD) such that the greater the deprivation in an area, the higher the rate of cataract surgery [11]; this suggests that, under the National Health Service (NHS), access to care seems not to be significantly compromised in socially deprived local authorities
Using longitudinal data and survival analysis techniques, this study aims to identify whether individual wealth inequalities lead to an unequal uptake of cataract surgery among older people in England, having controlled for the effects of other socioeconomic and medically relevant factors
Summary
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 live with untreated cataracts. Where cataract surgery uptake is the specific focus of enquiry, Kennan et al have argued that the rate of cataract surgery by local authority showed a positive correlation with the index of multiple deprivation (IMD) such that the greater the deprivation in an area, the higher the rate of cataract surgery [11]; this suggests that, under the NHS, access to care seems not to be significantly compromised in socially deprived local authorities This finding does not take into account other socioeconomic factors that may be influencing these observed gradients [12], and is based on aggregate, geographical data rather than individual markers of need. Using longitudinal data and survival analysis techniques, this study aims to identify whether individual wealth inequalities lead to an unequal uptake of cataract surgery among older people in England, having controlled for the effects of other socioeconomic and medically relevant factors
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