Evaluating barriers to access for cataract surgery in Waikato: analysis of calculated driving distance and visual acuity.

Aim: This cross-sectional study aimed to investigate whether presenting visual acuity or patient demographic variables were associated with geographic proximity to primary and secondary ophthalmic services.

Methods: Demographics for all patients referred within the Waikato District between October 2017 and March 2019 that met the threshold for publicly funded cataract surgery were analysed. GPS coordinates for all patient and optometrist addresses were obtained. The driving distance and driving time for each patient to travel to their referring optometrist were calculated. Quality-of-life data were obtained. Analysis of visual acuity, driving distance, age, ethnicity and gender was completed using. Furthermore, a comparative analysis of Māori and New Zealand European defined as having remote access was completed.

Results: A total of 1,260 patients were included. Multivariate analysis showed no significant association between driving distance and visual acuity. Comparative analysis of Māori and New Zealand European defined as having remote access showed Māori had significantly worse visual acuity than New Zealand Europeans at the time of referral. No significant difference was found in quality of life. Māori were on average younger than New Zealand European. Driving time and distance were on average 27% longer for Māori compared with New Zealand Europeans defined as having remote access.

Conclusions: Māori presenting with cataract typically are younger and have lower visual acuity than New Zealand European. Longer driving distances represent a potential geographic barrier for Māori to access ophthalmic care and referral to tertiary services. No significant association was found between driving distance and visual acuity.