Evidence map›Paper›PMID 42426671›Full record

Observational studyBMC ophthalmology2026

Association between social vulnerability index and cataract surgery care in medicare beneficiaries: a retrospective cohort study.

Kelly C Nguyen, Taylor Hall, Siqi Gan, Erica Langnas, John Boscardin, Catherine Q Sun, Sei Lee, Catherine L Chen

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kelly C Nguyen *University of California, San Francisco School of Medicine, San Francisco, CA, USA. kelly.nguyen5@ucsf.edu.
Taylor Hall *Department of Anesthesia, Stanford University, Stanford, CA, USA.
Siqi GanDivision of Geriatrics, University of California, San Francisco, San Francisco, CA, USA.
Erica LangnasPhilip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA.
John BoscardinDepartment of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
Catherine Q SunDepartment of Ophthalmology, University of California, San Francisco, CA, USA.
Sei LeeDivision of Geriatrics, University of California, San Francisco, San Francisco, CA, USA.
Catherine L ChenPhilip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA.

Funding

Mentoring Patient-Oriented Research to Individualize Care for Hospitalized Older Adults with and without Alzheimer's Disease and Related DementiasK24AG066998 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Sei Lee · 2021 to 2026
$1.1M
Frailty and Monitored Anesthesia Care for Cataract Surgery in Older Adults - Administrative SupplementK23AG072035 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CHEN, CATHERINE LEE · 2021 to 2025
$1.1M
NIA NIH HHS AG066998NIA NIH HHS K23 AG072035NIA NIH HHS K24 AG066998NIH National Institute on Aging AG072035
6 · The paper itself

Abstract

backgroundSocial vulnerability index (SVI) has been used as a surrogate measure to assess social determinants of health (SDOH) when conducting health disparities research, but the impact of SVI on the timing, receipt, and outcomes of cataract care in a nationally representative population of patients is unknown.

methodsA retrospective observational cohort study of Medicare fee-for-service beneficiaries aged 66 + in 2014 without a prior diagnosis of cataract disease was conducted to determine who went on to develop cataract disease and undergo cataract surgery between 2014 and 2021. A Fine and Gray sub-distribution hazard model was used to determine the association between SVI quartile, time to diagnosis and time to cataract surgery. Logistic regression was used to assess the association between SVI quartile and the incidence of ophthalmic complications.

resultsAmong 170,778 Medicare beneficiaries aged 66 + years of age at the start of the study period, 50.2% identified as female, 7.0% Black, 4.4% Hispanic, and 80.9% White. Fewer beneficiaries residing in high SVI (higher vulnerability) regions were diagnosed with cataracts (Quartile 4 55.9% vs. Q1 67.1%, p < 0.001) and underwent cataract surgery (Q4 19.4% vs. Q1 21.1%, p < 0.001) compared to beneficiaries in low SVI regions. After adjusting for patient demographics, overall health and frailty status, and health systemic characteristics including region, urban/rural location and number of ophthalmologists per capita, patients residing in higher SVI areas had lower rates of diagnosis (Q2 HR: 0.92 95% CI (0.91, 0.94); Q3 0.86 (0.84, 0.87); Q4: 0.78 (0.77, 0.80), reference=Q1) and cataract surgery (Q3 HR: 0.95, 95% CI (0.92, 0.98) and Q4: 0.90 (0.87, 0.93), respectively, reference=Q1). However, once a diagnosis was made, patients residing in higher SVI regions had higher rates of cataract surgery (Q2 HR: 1.04 (1.01, 1.07); Q3: 1.06 (1.03, 1.09); and Q4: 1.08 (1.05, 1.12), respectively, reference=Q1). There was no association between SVI and ophthalmic complications.

conclusionsHigher SVI is associated with disparities in receipt of cataract surgery among Medicare beneficiaries, which may be mediated by delays in cataract diagnosis. Reducing SDOH-related barriers to timely diagnosis in under-resourced areas could shorten the overall time to cataract surgery in this population.

Indexed as

CataractCataract ExtractionMedicareSocial VulnerabilityAgedAged, 80 and overFemaleHealthcare DisparitiesHumansMaleRetrospective StudiesSocial Determinants of HealthSocioeconomic Disparities in HealthUnited StatesCataract diagnosisCataract surgeryHealth disparitiesMedicareSocial determinants of healthSocial vulnerability index

Identifiers

PMID42426671
PMCPMC13348854

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.