Objective:

To assess the impact of the Social Vulnerability Index (SVI) on the timing, receipt, and outcomes of cataract care among Medicare beneficiaries.

Approach:

• Study Design: Retrospective cohort study evaluating the relationship between SVI, receipt of cataract surgery, and surgical outcomes.
• Data Source: Utilized US Centers for Medicare & Medicaid (CMS) research identifiable files from 2013 to 2021, representing a 20% sample of Medicare beneficiaries.
• Study Cohort: Included Medicare beneficiaries aged 66 in 2014 without a prior cataract diagnosis, excluding those with certain comorbidities or emergent surgeries.
• Cataract Care Events: Defined new cataract diagnosis and completion of ocular biometry and cataract surgery using specific ICD and CPT codes.
• Definition of SVI: Linked beneficiaries' zip codes to SVI census tracts using census data to stratify patients into quartiles based on social vulnerability.
• Identification of Complications: Used ICD-10 codes to identify ophthalmic complications within 30 days post-procedure.

Key Findings:

• Patients in higher SVI areas experienced more delays in cataract care.
• Higher SVI scores were associated with increased incidence of perioperative complications.

Interpretation:

Disparities in cataract surgery access and outcomes were observed based on social vulnerability.

Limitations:

• The study is limited to Medicare beneficiaries and may not be generalizable to other populations.
• Data is retrospective and may be subject to biases inherent in claims data.

Conclusion:

Social vulnerability impacts the timing and outcomes of cataract surgery in Medicare recipients.

Sources:

• CDC/ATSDR SVI