Expediting cataract surgery in New Zealand is cost-effective for falls prevention and improving vision-so what might be the next steps?

Multifactorial individual assessment with interventions tailored to the individual's risk factors can reduce the rate of falls and risk of fractures. Assessment of vision is one key aspect of multifactorial assessment and first eye cataract surgery reduces the rate of falls. We recently modelled the impact of expediting first eye cataract surgery in New Zealand for falls prevention (Boyd et al Injury Prevention). The model used was the same model used for previous modelling of home safety assessment and modification and community exercise programmes. This study found that expedited cataract surgery was highly cost-effective by generating a quality-adjusted life-year (QALY) for NZ$10,600 (95%UI: NZ$6,030-15,700). Routine cataract surgery itself (relative to no such surgery being available) was even more cost-effective at $4,380 per QALY gained, when considering vision benefits and falls prevention benefits. In this viewpoint article, we discuss the potential next steps for expediting cataract surgery and further improving its cost-effectiveness in the New Zealand setting.