How fair is cataract prioritisation?

AIM

The purpose of the study was to examine the reliability of cataract prioritisation assessments.

METHOD

Thirty-nine subjects awaiting cataract surgery were independently assessed by two examiners, each using two different prioritisation forms, to assign priority scores. The scores obtained by the two examiners were analysed for consistency.

RESULTS

The scores awarded to the same subjects by different examiners varied by as much as 26 points (out of a possible 100).

CONCLUSIONS

The current cataract assessment process is inconsistent and of questionable validity for establishing a prioritised list of individuals awaiting cataract surgery. The policy of setting a rigid threshold score, below which patients do not qualify for surgery in the public sector, is inequitable and must be reviewed in the interests of fair delivery of health care. Prioritisation methods for other disorders should be reviewed to determine their validity.