# Nationwide analysis of sex differences in waiting times for cataract surgery in Sweden between 2010 and 2022

## TL;DR

The study finds that in Sweden, women waited slightly longer for cataract surgery than men, even after adjusting for factors like age and health conditions.

## Contribution

This is the first nationwide analysis of sex differences in cataract surgery waiting times in Sweden over a 12-year period.

## Key findings

- Females had a mean waiting time of 64 days versus 60 days for males, with a consistent gap across all regions and vision levels.
- Linear mixed-effects modeling showed males had a 3.3-day shorter waiting time compared to females.
- Female sex, older age, comorbidities, and region were significant predictors of longer waiting times.

## Abstract

Sex-based disparities in healthcare access remain a global challenge. We aimed to investigate differences in waiting times for cataract surgery between males and females in Sweden, hypothesizing that such disparities might persist even within a universal healthcare system.

We performed a nationwide retrospective cohort study using data from the Swedish National Cataract Register, which includes over 93% of all cataract surgeries. A total of 1,413,652 patients over 40 years of age who underwent cataract surgery between 2010 and 2022 were included. Exclusions were applied to those with waiting times exceeding 24 months and those residing outside Sweden. The primary outcome was waiting time between preoperative assessment and surgery, stratified by visual acuity, region, and demographic and clinical factors.

Here we show a mean waiting time of 64 days (standard deviation 126) for females and 60 days (standard deviation 102) for males (P < 0.001). This difference persists across all visual acuity strata and regions. A linear mixed-effects model with region as a random intercept indicates that males have a 3.3-day shorter waiting time compared to females (P < 0.001). Multivariate hazards regression identifies female sex, older age, specific comorbidities, and region of residence as significant predictors of longer waiting times. Although overall waiting times decrease over the study period, the sex-based gap remains consistent.

We observe a persistent, albeit small, difference in waiting times favoring males. These findings highlight a systemic disparity that warrants further investigation and targeted interventions to ensure equitable access to cataract care.

This study looked at differences in waiting times for cataract surgery between males and females in Sweden, using data from over 1.4 million patients between 2010 and 2022. Cataracts cause clouding of the eye’s lens and require surgery for treatment. Females waited an average of 64 days for surgery compared to 60 days for males. This small but consistent difference was seen across all levels of vision impairment and in all regions of Sweden. Even after accounting for other factors, including age, other eye conditions, and region, females still faced longer delays. While these differences are unlikely to affect health outcomes, they may point to inequities in the healthcare system. Efforts are needed to ensure fair and equal access to cataract surgery, regardless of sex.

Jute and Stålhammar analyze nationwide data on cataract surgery waiting times in Sweden. They show that between 2010 and 2022 females experienced modestly longer delays than males.