Purpose: To evaluate the prevalence, surgical trends, and economic burden of cataract among Medicare beneficiaries aged 65 and older in the United States.
Design: Retrospective cohort study.
Subjects: Medicare beneficiaries aged ≥65 years diagnosed with cataract between 2014 and 2021, as reported by the Centers for Disease Control and Prevention's Vision and Eye Health Surveillance System (VEHSS).
Methods: Cataract cases in the cohort were identified using ICD-9 and ICD-10 codes, and surgical interventions were determined using CPT codes. Annual prevalence and surgical trends were assessed. Additionally, we performed the analyses of the data, stratified by sex and racial/ethnic groups. Economic burden estimates incorporated inflation-adjusted direct and indirect costs..
Main outcome measures: Prevalence of cataract, surgical treatment rates, Medicare reimbursements, and per-person economic burden of untreated cataract.
Results: Cataract prevalence increased from 36.38% in 2014 to 37.03% in 2021, with an estimated national burden rising from 15.7 million to 19.6 million cases. Females showed a significantly higher prevalence than males Cataract prevalence was highest among White individuals, followed by Asian, Native American, Black, and Hispanic populations. Annual cataract surgeries plateaued at approximately 1.4 million, with Black beneficiaries having the lowest surgical rates. Inflation-adjusted Medicare reimbursements for cataract surgery decreased from $1.015 billion in 2014 to $741 million in 2021, while the per-person economic burden of untreated cataract increased from $33,362 in 2014 to $38,955 in 2021.
Conclusions: Cataract prevalence among older adults in the U.S. is rising, while surgical access is stagnant, with notable racial disparities and declining Medicare reimbursements. The increasing economic burden of untreated cataracts underscores the need for targeted policies to improve equitable access to surgical care.
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