Cataract surgery among veterans 65 years of age and older: Analysis of national veterans health administration databases

The authors examine the rates of cataract surgery as a crude measure of appropriateness of care among veterans 65 years of age and older who use Veterans Health Administration (VHA). Data were obtained from the national VHA data sets for fiscal years 2000 through 2007, using International Classification of Diseases codes and the American Medical Association's Current Procedural Terminology codes. Cataract surgery was expressed as procedures per 10 000 veteran beneficiaries per fiscal year. The annual incidence of cataract surgery increased marginally over the study period with an average annual incidence of 105.8 surgeries per 10 000 beneficiaries. Institutional rates of VHA surgery differ substantially from those of Medicare beneficiaries, which are approximately 5.5-fold greater. Although direct comparison must be interpreted cautiously, the difference is too great to be explained by demographic factors or secular trends in surgery. Additional research is required to elucidate factors that influence the rate of cataract surgery in the VHA.