title: A Cross-Sectional Retrospective Analysis of the Racial and Geographic Variations in Cataract Surgery.
abstract: BACKGROUND
  Cataract surgery is the most common surgery performed on beneficiaries of Medicare, accounting for more than $3.4 billion in annual expenditures. The purpose of this study is to examine racial and geographic variations in cataract surgery rates and determine the association between the racial composition of the community population and the racial disparity in the likelihood of receiving necessary cataract surgery.
  
  
  METHODS
  Using the national prevalence rates from the National Institute of Eye Health and the 2010 Healthcare Cost and Utilization Project-Florida State Ambulatory Surgery Database, we determined the estimated cases of cataract and the actual number of cataract procedures performed, on four race/gender determined groups aged 65 and over in the state of Florida in 2010. The utilization rates and disparity ratios were also calculated for each Florida county. The counties were segmented into groups based on their racial composition. The association between racial composition and disparity ratios in receiving necessary cataract surgery was examined. The Geographic Information System was used to display county-level geospatial relationships.
  
  
  RESULTS
  African-Americans have a lower gender-specific cataract prevalence (African-American male = 0.246, African-American female = 0.392, white male = 0.368, and white female = 0.457), but they are also less likely than whites to receive necessary cataract surgery (utilization rate: African-American male = 7.92%, African-American female = 6.17%, white male = 12.08%, and white female = 10.54%). The statistical results show no overall differences between the disparity ratios and the racial composition of the communities. However, our geospatial analyses revealed a concentration of high racial disparity/high white population counties largely along the West Coast and South Central portion of the state.
  
  
  CONCLUSIONS
  There are racial differences in the likelihood of receiving necessary cataract surgery. However, there is no significant statewide association between the racial composition of the community population and the racial disparity in the likelihood of receiving necessary cataract surgery. Geospatial techniques did, however, identify subpopulations of interest which were not otherwise identifiable with typical statistical approaches, nor consistent with their conclusions.
authors.affiliation: Department of Health Services Research, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, North Carolina, United States of America.
authors.forename: Sara
authors.initials: S
authors.lastname: Shahbazi
authors.affiliation: Department of Public Health Sciences, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, North Carolina, United States of America.
authors.forename: James
authors.initials: J
authors.lastname: Studnicki
authors.affiliation: Department of Public Health Sciences, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, North Carolina, United States of America.
authors.forename: Charles Wayne
authors.initials: CW
authors.lastname: Warner-Hillard
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000453:epidemiology*; D002387:Cataract Extraction / Q000379:methods; D003430:Cross-Sectional Studies; D005260:Female; D005431:Florida / Q000453:epidemiology; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data; D044469:Racial Groups / Q000706:statistics & numerical data*; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014481:United States; D044465:White People / Q000706:statistics & numerical data