CATARACT-SURGERY IN SOUTH-WEST THAMES REGION - AN ANALYSIS OF AGE-ADJUSTED SURGERY RATES AND LENGTH OF STAY BY DISTRICT

Although the frequency of cataract surgery has increased in the UK, th e demand is still not being met. There is no evidence of whether Regio nal Health Authorities are meeting the national target of 150 cataract operations per 100,000 population. This paper describes variations in age-standardised rates of cataract surgery and lengths of hospital st ay (LOS) between the 13 health districts in South West Thames Regional Health Authority (SWTRHA). A retrospective analysis of cataract surge ry performed on South West Thames (SW Thames) residents during 1990 wa s undertaken using the Korner hospital activity data system. The resid ents of SW Thames Region had 6,729 cataract operations in 1990, produc ing an overall surgery rate of 266 per 100,000 resident population. Tw o-thirds of the operations were performed on women, and the greatest n umber of operations were in the 75-79 and 80-84 year age bands. Women aged over 75 had significantly higher age-specific surgery rates than their male counterparts. The mean age for women was 76.6 years and for men 71.9 years; 12% of cases had a length of stay less than a day (da y cases) and 49% were discharged within two days. There were substanti al variations in LOS between health districts. Age-adjusted rates reve aled significant variations between districts, four of which had rates below the regional average. The crude cataract surgery rate for SW Th ames residents has increased threefold since 1975. Women have a signif icantly higher rate of surgery, which may be due to social factors. Va riations in LOS between districts cannot be explained by difference in age structure and may be caused by local custom and practice. It is p ossible for national, regional and district cataract rates to be calcu lated, and they are a useful indicator of how the need for cataract su rgery is being met in the population.