Brian C Stagg1,2, HwaJung Choi3,4,5, Maria A Woodward1,4, Joshua R Ehrlich1,4,5. 1. Center for Eye Policy and Innovation, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor. 2. National Clinician Scholars Program, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor. 3. Department of Internal Medicine, University of Michigan, Ann Arbor. 4. Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor. 5. Michigan Center on the Demography of Aging, Institute for Social Research, University of Michigan, Ann Arbor.
Abstract
Importance: Cataract-related vision impairment is an important public health issue that tends to affect older adults. Little is known about the association between older adults' social support networks and their likelihood of receiving cataract surgery. Objective: To determine if older adults with smaller social support networks are less likely to receive cataract surgery. Design, Setting, and Participants: Retrospective cohort study. The National Health and Aging Trends Study, a nationally representative US survey, administered annually from 2011 to 2015 to a cohort of Medicare beneficiaries 65 years and older with no cataract surgery prior to the start of the study. Main Outcomes and Measures: Multivariable logistic regression was performed to evaluate if the number of persons in an individual's social support network influenced whether that individual received cataract surgery during a given year of the study. Results: Overall, 3448 participants were interviewed from 2011 to 2015 for a total of 9760 observations. Of these observations, 3084 (weighted, 38.81%; 95% CI, 37.28-40.35) were aged 70 to 74 years, 5211 (weighted, 52.32%; 95% CI, 50.19-54.44) were women; 5899 (weighted, 78.53%; 95% CI, 76.29-80.61) were white, 2249 (weighted, 9.55%; 95% CI, 8.45-10.78) were black, 537 (weighted, 7.18%; 95% CI, 5.88-8.73) were Hispanic, and 303 (weighted, 4.74%; 95% CI, 3.56-62.9) reported other races. Medicare beneficiaries with smaller social support networks (0-2 individuals) were less likely to receive cataract surgery in a given year (adjusted odds ratio, 0.60; 95% CI, 0.37-0.96) than those with larger support networks (≥3 individuals). The adjusted predicted proportion of Medicare beneficiaries undergoing cataract surgery was 4.7% (95% CI, 2.7%-6.7%) and 7.5% (95% CI, 6.9%-8.1%) for those with small and large social support networks, respectively. Having fewer non-spouse/partner family members in the support network was associated with decreased odds of receiving cataract surgery (adjusted odds ratio, 0.60; 95% CI, 0.43-0.85), but having spouses/partners (adjusted odds ratio, 0.97; 95% CI, 0.77-1.22) and nonfamily members (adjusted odds ratio, 0.90; 95% CI, 0.72-1.11) did not have a significant association. Conclusions and Relevance: Medicare beneficiaries with fewer non-spouse/partner family members in their social support networks were less likely to receive cataract surgery. These findings suggest that attention should be given to patients with smaller support networks to ensure that they receive cataract surgery when it is indicated.
Importance: Cataract-related vision impairment is an important public health issue that tends to affect older adults. Little is known about the association between older adults' social support networks and their likelihood of receiving cataract surgery. Objective: To determine if older adults with smaller social support networks are less likely to receive cataract surgery. Design, Setting, and Participants: Retrospective cohort study. The National Health and Aging Trends Study, a nationally representative US survey, administered annually from 2011 to 2015 to a cohort of Medicare beneficiaries 65 years and older with no cataract surgery prior to the start of the study. Main Outcomes and Measures: Multivariable logistic regression was performed to evaluate if the number of persons in an individual's social support network influenced whether that individual received cataract surgery during a given year of the study. Results: Overall, 3448 participants were interviewed from 2011 to 2015 for a total of 9760 observations. Of these observations, 3084 (weighted, 38.81%; 95% CI, 37.28-40.35) were aged 70 to 74 years, 5211 (weighted, 52.32%; 95% CI, 50.19-54.44) were women; 5899 (weighted, 78.53%; 95% CI, 76.29-80.61) were white, 2249 (weighted, 9.55%; 95% CI, 8.45-10.78) were black, 537 (weighted, 7.18%; 95% CI, 5.88-8.73) were Hispanic, and 303 (weighted, 4.74%; 95% CI, 3.56-62.9) reported other races. Medicare beneficiaries with smaller social support networks (0-2 individuals) were less likely to receive cataract surgery in a given year (adjusted odds ratio, 0.60; 95% CI, 0.37-0.96) than those with larger support networks (≥3 individuals). The adjusted predicted proportion of Medicare beneficiaries undergoing cataract surgery was 4.7% (95% CI, 2.7%-6.7%) and 7.5% (95% CI, 6.9%-8.1%) for those with small and large social support networks, respectively. Having fewer non-spouse/partner family members in the support network was associated with decreased odds of receiving cataract surgery (adjusted odds ratio, 0.60; 95% CI, 0.43-0.85), but having spouses/partners (adjusted odds ratio, 0.97; 95% CI, 0.77-1.22) and nonfamily members (adjusted odds ratio, 0.90; 95% CI, 0.72-1.11) did not have a significant association. Conclusions and Relevance: Medicare beneficiaries with fewer non-spouse/partner family members in their social support networks were less likely to receive cataract surgery. These findings suggest that attention should be given to patients with smaller support networks to ensure that they receive cataract surgery when it is indicated.
Authors: Xiu Juan Zhang; Vishal Jhanji; Christopher Kai-Shun Leung; Emmy Y Li; Yingpeng Liu; Chongren Zheng; David C Musch; David F Chang; Yuan Bo Liang; Dennis S C Lam Journal: Ophthalmic Epidemiol Date: 2014-04-22 Impact factor: 1.648
Authors: Sebastian Briesen; Robert Geneau; Helen Roberts; Jael Opiyo; Paul Courtright Journal: Trop Med Int Health Date: 2010-03-01 Impact factor: 2.622
Authors: Nakul S Shekhawat; Michael V Stock; Elizabeth F Baze; Mary K Daly; David E Vollman; Mary G Lawrence; Amy S Chomsky Journal: Ophthalmology Date: 2017-05-16 Impact factor: 12.079
Authors: Mark M Theiss; Michael W Ellison; Christine G Tea; Julia F Warner; Renee M Silver; Valerie J Murphy Journal: Orthopedics Date: 2011-05-18 Impact factor: 1.390
Authors: Nathan Congdon; Benita O'Colmain; Caroline C W Klaver; Ronald Klein; Beatriz Muñoz; David S Friedman; John Kempen; Hugh R Taylor; Paul Mitchell Journal: Arch Ophthalmol Date: 2004-04
Authors: Cheryl R Clark; Leroi S Hicks; Joseph H Keogh; Arnold M Epstein; John Z Ayanian Journal: J Gen Intern Med Date: 2008-05-14 Impact factor: 5.128
Authors: Lesley D Gillespie; M Clare Robertson; William J Gillespie; Catherine Sherrington; Simon Gates; Lindy M Clemson; Sarah E Lamb Journal: Cochrane Database Syst Rev Date: 2012-09-12
Authors: Xiaoling Xiang; Vicki A Freedman; Khushali Shah; Rita X Hu; Brian C Stagg; Joshua R Ehrlich Journal: J Gerontol A Biol Sci Med Sci Date: 2020-02-14 Impact factor: 6.053
Authors: Jacqueline Ramke; Fatima Kyari; Nyawira Mwangi; Mmpn Piyasena; Gvs Murthy; Clare E Gilbert Journal: Int J Environ Res Public Health Date: 2019-10-12 Impact factor: 3.390