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HomeminewsPrioritise Cataract Surgery, Report Finds

Prioritise Cataract Surgery, Report Finds

Government investment in public cataract services should be a health policy priority, according to a report commissioned by Vision 2020.

Conducted by the University of New South Wales, the report found reducing wait lists for cataract surgery would deliver savings to the health system, societies and individuals, while also increasing patient quality of life years (QALY).

The researchers analysed available data to determine the (pre-COVID) unmet need for public cataract surgery and additional costs associated with these waits.

243,139 Australians currently live with visually significant cataract

It estimated that 243,139 Australians currently live with visually significant cataract (visual acuity worse than 6/12), including 10,616 Aboriginal and Torres Strait Islander people and 232,523 non-Indigenous Australians. This number is expected to increase to 308,516 by 2030 due to our aging population.

Currently, about 29% of cataract surgeries for non-Indigenous Australians and 80% of cataract surgeries for Aboriginal and Torres Strait Islander people are performed in the public hospital system. Median waiting times, from referral to admission for surgery, range from three to 18 months, with a few patients waiting more than two years for surgery.

COSTS OF WAITING

The report calculated significant costs to the health system associated with wait periods, due to falls and vehicle accidents caused by cataract-impaired vision.

By reducing wait periods for cataract surgery to one month (from referral to surgery admission), and hence the associated costs, it estimated the health system would save $4.71M, $11.77M and $10.63M over three years, (compared to costs associated with three-, six- and 12-month waits).

With respect to quality of life, the report highlights strong evidence in favour of cataract surgery compared to no intervention. While the number of QALYs gained following initial cataract surgery slightly exceeded that with second eye surgery, both procedures were considered cost-effective. Analysis in the United States estimated cataract surgery delivered a 4,567% financial return on investment to society over 13 years.

To reduce the impact of cataract, the authors recommended investment in:

  • Streamlined pathways to access cataract surgery, including standardised referral and triage processes to ensure referrals are appropriately targeted,
  • Higher volume cataract surgery services for public patients in public (or private) hospitals to meet demand and reduce waiting time for surgery,
  • Financial incentives to promote high quality outcomes and efficiency in public hospital services while maintaining eye surgery training programs for ophthalmology trainees, and
  • Increased provision of surgical services linked to outreach and regional cataract assessment services to address current inequity in access and longer wait time for public cataract services for Aboriginal and Torres Strait Islander peoples.

Reference 

Jessie Huang, Blake Angell, Anna Palagyi, Peter McCluskey, Andrew White, Judith Abbott, Lisa Keay. On behalf of Vision2020. Data Compilation and Analysis to Inform Development of Strategy to Improve Access to Public Cataract Services in Australia. 18 August 2021. www.vision2020australia. org.au/wp-content/uploads/2021/03/Report-on-Access-to- Public-Cataract-Services-in-Australia_Full-Report-2021.pdf 

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