Insurance cover among elderly cataract patients falls below 17%

Time of India

a day ago

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Visakhapatnam: A recent study of electronic medical records from 38,387 patients aged over 70 who underwent cataract surgery revealed alarmingly low insurance uptake — just 16.07%.
The analysis covered new patients visiting four tertiary centres and their associated primary and secondary facilities in Andhra Pradesh, Odisha, Telangana, and Karnataka between August 2011 and December 2022.
The insurance uptake declined markedly with age, falling from 17.52% among the 'youngest old' (70–74 years) to just 7.14% among the 'oldest old' (above 90 years). Private insurance coverage dropped significantly from 13.3% among 70-year-olds to a mere 4.7% among 90-year-olds, whereas publicly funded insurance remained relatively constant at 3.3% to 4.2%.
A notable gender disparity was also observed. Elderly males had higher insurance uptake (19.11%) compared to females (12.43%).
This trend was consistent across all subgroups analysed.
Insurance uptake significantly increased during 2018-2022 compared to 2011-2017 (20.61% vs. 10.65%). The study attributed this rise largely to major policy interventions such as the Ayushman Bharat scheme launched in 2018, which doubled insurance coverage for patients over 70.
This was the strongest predictor for insurance uptake in surgeries conducted after 2018. Remarkably, nearly all patients (184 out of 189) who were initially offered free, fully subsidised care opted to switch to govt insurance before surgery, demonstrating the perceived value and utility of public insurance schemes.
Crucially, insurance coverage was associated with better visual outcomes post-cataract surgery.
Insured patients were 1.38 times more likely to achieve good visual results than uninsured ones, particularly those aged above 80. However, disparities persisted within the insured population. Patients with government insurance faced longer median waiting times (18 days) compared to privately insured patients (11 days), and government approvals were three times slower.
Moreover, privately insured patients were substantially more likely to receive modern foldable intraocular lenses (79.55%) compared to those with government insurance (53.46%).
"This study is powerful evidence that adequate insurance coverage improves the chances of receiving timely health care while also benefiting from superior outcomes. I would argue that these findings are true not just for cataract surgery, but for all forms of health intervention," said Dr Brijesh Takkar, consultant ophthalmologist at the L V Prasad Eye Institute and first author of the study.
Dr Raja Narayanan, one of the corresponding authors, added, that they found that insurance uptake is uniformly low across India's elderly population.
"And the coverage declined dramatically in patients over 80 years of age. Lacking insurance was associated with poorer visual outcomes," said Dr Narayanan.
This study, published in The Lancet Regional Health – Southeast Asia, demonstrates a critical need for regulatory reforms to expand and incentivise eye care-related insurance coverage across this highly vulnerable age group. It also underscores the urgency of closing gender-related gaps to advance equitable healthcare access.
The other researchers involved in the study included Ragukumar Venugopal, Mehul Mehta, Anthony Vipin Das, Varsha Rathi, Rohit Khanna, Gudlavalleti VS Murthy, Hemendra Kumar Vaishnav, Brijesh Kashyap, and Chirantan Chatterjee, affiliated with various academic and healthcare institutions across India, the USA, and the UK.