Cost Analysis of Immediately versus Delayed Sequential Bilateral Cataract Surgery at a Community Based Ambulatory Surgical Center.

Theme: Cataract surgery*
What: Cataract surgery
Part of: Cataract III: Innovations and research in cataract surgery / Cataracte III: 3. Innovations et recherches en chirurgie de la cataracte
When: 6/2/2024, 11:15 AM - 12:45 PM
Where: Room | Salle 801

Abstract

Purpose/Study Design: A prospective chart review was conducted to assess the cost-effectiveness of immediately sequential bilateral cataract surgery (ISBCS) versus delayed sequential cataract surgery (DSBCS) among Canadian adults over the age of 65 who undergo different sequencing of cataract extraction surgery at a community ambulatory surgical-based center (C-ASC) in the Greater Toronto Area following the COVID-19 pandemic.

Methods: Cost metrics were collected from 202 patients who underwent either DSBCS or ISBCS at one of two CACs between January 2022 and January 2023. Data consisted of direct and indirect costs. Direct cost measures included pre-, intra-, and post-operative surgical expenses. Pre-operative measures included diagnostic and consultation fees. Intra-operative metrics consisted of medical and non-medical labor, anesthesia fees, and consumables (including amortized cost of equipment and sterilization). Post-operative surgical costs included post-operative follow-up visits at post-operative day 0 (POD0) and post-operative week 1 (POW1). Indirect costs were measured by time lost due to travel and additional post-operative visits (any visits other than required POD0 and POW1).

Results: The average surgical costs were reduced by 20.23% when performing ISBCS (p <0.001); the average total cost of DSBCS was $1617.18 compared to $1352.03 for ISBCS. Average direct surgical costs were found to be $1491.09 and $1249.41 for DSBCS and ISBCS respectively (p <0.001), whereas average indirect costs were calculated to be $126.09 and $103.62 (p = 0.059). Additional post-operative visits accounted for a significant proportion of the difference in indirect costs between study groups (p = 0.010). No other variables, including current comorbidity, pre-and intra-operative ocular metrics, and perioperative systemic vitals had a significant effect on cost-effectiveness between ISBCS and DSBCS.

Conclusions: Average costs of cataract extraction in a community ambulatory surgical center were significantly reduced when performing ISBCS compared to DSBCS.

 

Presenter(s)

Presenting Author: Francesca Lee

Additional Author(s):

Sohel Somani, Uptown Eye Specialists

Steve Arshinoff, North York Eye Associates

Hannah Chiu, Uptown Eye Specialists

Lili Tong, Uptown Eye Specialists

Eric Tam, Uptown Eye Specialists

Zaynab Somani, Uptown Eye Specialists

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