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Should Rates of Cataract Surgery Vary by Insurance Status?

Stephen A. Obstbaum, MD
JAMA. 1997;277(22):1807-1808. doi:10.1001/jama.1997.03540460071035.
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In this issue of JAMA, Dr Goldzweig and colleagues1 report their findings on the rates of cataract surgery in 2 prepaid settings and in a fee-for-service setting, all in Southern California. The results of this retrospective analysis of encounter and claims data, of a beneficiary population aged 65 years and older, indicate that cataract surgery is performed at lower rates in the 2 prepaid settings compared with the fee-for-service model. Since cataract surgery is performed on about 1.4 million patients each year and is the greatest single Medicare expenditure annually, an analysis of its frequency in various settings is fitting.2 (An overview of the natural history, risk factors, signs and symptoms, indications for surgery, techniques of cataract surgery, complications, and postoperative care was recently published in Clinical Crossroads.3) The study by Goldzweig et al1 raises the issue of whether the lower rate of cataract surgery in


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