Disparities in cataract surgery between Aboriginal and non-Aboriginal people in New South Wales, Australia

Randall, D. A., Reinten, T., Maher, L., Lujic, S., Stewart, J., Keay, L., Leyland, A. H. and Jorm, L. R. (2014) Disparities in cataract surgery between Aboriginal and non-Aboriginal people in New South Wales, Australia. Clinical and Experimental Ophthalmology, 42(7), pp. 629-636. (doi:10.1111/ceo.12274) (PMID:24299196) (PMCID:PMC4233999)

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Abstract

Background: To investigate variation in rates of cataract surgery in New South Wales (NSW), Australia by area of residence for Aboriginal and non-Aboriginal adults.

Design: Observational data linkage study of hospital admissions.

Participants: 289 646 NSW residents aged 30 years and over admitted to NSW hospitals for 444 551 cataract surgery procedures between 2001 and 2008.

Methods: Analysis of linked routinely collected hospital data using direct standardisation and multilevel negative binomial regression models accounting for clustering of individuals within Statistical Local Areas (SLAs).

Main outcome measures: Age-standardised cataract surgery rates and adjusted rate ratios (ARRs).

Results: Aboriginal people had lower rates of cataract procedures than non-Aboriginal people of the same age and sex, living in the same SLA (ARR 0.71, 95% CI 0.68-0.75). There was significant variation in cataract surgery rates across SLAs for both Aboriginal and non-Aboriginal people, with the disparity higher in major cities and less disadvantaged areas. Rates of surgery were lower for Aboriginal than non-Aboriginal people in most SLAs, but in a few, the rates were similar or higher for Aboriginal people.

Conclusions: Aboriginal people in NSW received less cataract surgery than non-Aboriginal people, despite evidence of higher cataract rates. This disparity was greatest in urban and wealthier areas. Higher rates of surgery for Aboriginal people observed in some specific locations are likely to reflect the availability of public ophthalmology services, targeted services for Aboriginal people and higher demand for surgery in these populations.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Leyland, Professor Alastair
Authors: Randall, D. A., Reinten, T., Maher, L., Lujic, S., Stewart, J., Keay, L., Leyland, A. H., and Jorm, L. R.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Journal Name:Clinical and Experimental Ophthalmology
Publisher:Wiley
ISSN:1442-6404
ISSN (Online):1442-9071
Copyright Holders:Copyright © 2014 The Authors
First Published:First published in Clinical and Experimental Ophthalmology 42(7):629-623
Publisher Policy:Reproduced under a Creative Commons License

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