The following is a summary of “Prevalence and cost of routine preoperative care for low-risk cataract surgery a decade after Choosing Wisely,” published in the May 2024 issue of Ophthalmology by Rung et al.
In the U.S., procedural clearance tests and examinations are expensive for people preparing for surgery for low-risk cataracts.
Researchers conducted a retrospective study to determine the factors that make people more likely to get these tests and if opting for tests affects any problems after surgery.
They enrolled patients from a large healthcare organization claims analysis aged ≥65 half a year before and after cataract surgery between 2018 and 2021. The exams/tests were identified by looking at codes in member claims, like blood panels and diagnostic codes before surgery. The prevalence and cost of the tests were also estimated, and mixed effects modeling was used to see what predicted getting these tests and any problems after surgery.
The results showed that up to 42% of cataract surgery patients visited a doctor for clearance, and up to 23% got tests. Preoperative visits and tests totaled $4.3 million, around $107-$114 per patient. Member traits didn’t differ much between those getting tests and those not. Surgical facilities and care teams were critical predictors of pre-op care, and facilities were stronger predictors than care teams. Adverse events were rare and not linked to pre-op testing.
Investigators concluded that rates of pre-op testing for cataract surgery haven’t changed much despite efforts like the ‘Choosing Wisely’ campaign to reduce them. Many pre-op evaluations, probably unnecessary, were common, suggesting reconsidering current practices, especially at the facility level.
Source: sciencedirect.com/science/article/abs/pii/S0161642023008710
