Racial/ethnic differences in rates of complex cataract surgery among United States Medicare beneficiaries

Abstract

To determine racial/ethnic differences in rates of complex cataract surgery among United States Medicare beneficiaries. Departments of Ophthalmology and Health Science Research, Mayo Clinic, Rochester, Minnesota, USA. Retrospective case series. The U.S. Medicare 5% Limited Data Set, representing a 5% sample of over 28 million fee-for-service Medicare beneficiaries predominantly aged 65years and older, were analyzed for rates of complex cataract surgery (Current Procedural Terminology [CPT] code 66982) among all beneficiaries who had cataract surgery (CPT codes 66982, 66984), stratified by race/ethnicity between January 1, 2014, and December 31, 2014. Associations were tested by using multivariate regression analysis. Data from approximately 1 087 680 Medicare beneficiaries were analyzed. After adjustment for age and sex, the likelihood of complex cataract surgery was significantly higher in African Americans (odds ratio [OR], 1.90; 95% confidence interval [CI], 1.75-2.08), Asians (OR, 1.57; 95% CI, 1.34-1.85), and Hispanics (OR, 1.42; 95% CI, 1.18-1.71) than in whites among fee-for-service Medicare beneficiaries. Complex cataract surgery was more likely in men (OR, 1.83; 95% CI, 1.73-1.92) than in women, and the likelihood of complex cataract surgery increased in the elderly, with beneficiaries older than 84years more likely to have complex surgery (OR, 2.68, 95% CI, 2.45-2.93) than beneficiaries aged 65 to 69years. There were racial/ethnic differences in the likelihood of complex cataract surgery among fee-for-service Medicare beneficiaries; racial/ethnic minorities (Hispanics, Asians, and African Americans) were 42% to 90% more likely to have complex cataract surgery than whites.