Cost effect of surgeon and patient discretion in regard to cataract surgery
Authors Oostra TD, Mauger TF
Received 8 October 2018
Accepted for publication 27 November 2018
Published 10 December 2018 Volume 2018:12 Pages 2563—2565
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Tyler D Oostra,1 Thomas F Mauger2
1Havener Eye Institute, Department of Ophthalmology, The Ohio State University Wexner Medical Center, Columbus, OH 43212, USA; 2West Virginia University Eye Institute, Department of Ophthalmology, West Virginia University, Morgantown, WV 26506, USA
Purpose: The purpose of this study is to examine the cost effect of surgeon and patient discretion in regard to cataract surgery and how this affects population health care costs.
Methods: A model of cataract progression was created from preexisting published data and combined with mortality data and Medicare cataract statistics to estimate the effect of mortality on decreasing the rate of cataract surgery if surgery was delayed until any cataract progression occurred.
Results: Five-year cataract progression rates were determined for a given patient age, sex, and type of cataract. Combined with 5-year death rates, delaying surgery until progression occurred resulted in a 1.1% decrease in surgery for nuclear sclerosis at age 45 that increased to a 33.8% decrease by age 90; a 1.5% decrease in surgery for cortical cataract at age 45 that increased to a 51.1% decrease by age 90; and a 1.6% decrease in surgery for posterior subcapsular at age 45 that increased to a 59.7% decrease by age 90. The effect of this decrease in surgical volume on Medicare was estimated to result in a 13% overall decrease in cataract surgery annually at a cost of ~$660 million dollars per year.
Conclusion: Overall, we conclude that surgeon and patient discretion in regard to cataract surgery has a substantial cost effect with the potential to reduce surgical volume by as much as 13% by the decision to delay surgery as a result of patient mortality.
Keywords: cataract surgery, cataract progression, cost effect, health care costs
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