Factors associated with the utilization of cataract surgery for veterans dually enrolled in Medicare.
BACKGROUND
Cataract is the most common age-related disorder amenable to surgical correction in persons 65 years or older in the United States. Persons who are eligible for benefits through both the Veterans Health Administration (VHA) and Medicare have a choice in which system to receive medical care.


METHODS
We examined factors that might influence the choice of having cataract surgery through the VHA and fee-for-service Medicare using a national database from the VHA Information Resource Center.


RESULTS
In 2007, 159,094 dually eligible veterans had cataract surgery, with 137,726 (86.6%) having surgery in the private sector. Strong associations with the use of VHA for surgery were living within 20 miles of a facility, severity of service-connected disability, and low income or Medicaid eligibility.


CONCLUSIONS
The VHA remains an important safety net for many veterans who are dually enrolled in Medicare. Dependency on the VHA for quality of life surgery needs to be kept in mind if budgetary pressures lead to restrictions of VHA services for veterans with Medicare.
VA Center of Excellence on Implementing Evidence Based Practice, Regenstrief Institute Inc., Indianapolis, IN 46202, USA.
Dustin D
DD
French
Curtis E
CE
Margo
D000368:Aged; D002387:Cataract Extraction / Q000191:economics; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D006278:Medicare / Q000191:economics / Q000706:statistics & numerical data*; D014481:United States; D014493:United States Department of Veterans Affairs / Q000191:economics / Q000706:statistics & numerical data*; D014728:Veterans / Q000706:statistics & numerical data