Factors Associated With the Utilization of Cataract Surgery for Veterans Dually Enrolled in Medicare

Abstract

Cataract is the most common age-related disorder amenable to surgical correction in persons 65 years or older in the United States. Persons who are eligible for benefits through both the Veterans Health Administration (VHA) and Medicare have a choice in which system to receive medical care. We examined factors that might influence the choice of having cataract surgery through the VHA and fee-for-service Medicare using a national database from the VHA Information Resource Center. In 2007, 159,094 dually eligible veterans had cataract surgery, with 137,726 (86.6%) having surgery in the private sector. Strong associations with the use of VHA for surgery were living within 20 miles of a facility, severity of service-connected disability, and low income or Medicaid eligibility. The VHA remains an important safety net for many veterans who are dually enrolled in Medicare. Dependency on the VHA for quality of life surgery needs to be kept in mind if budgetary pressures lead to restrictions of VHA services for veterans with Medicare.