Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

The Content and Cost of Cataract Surgery

The Content and Cost of Cataract Surgery Abstract Although more than 1 million cataract surgeries are performed annually in the United States, little is known about the frequency of use or cost of various services provided in connection with this procedure. To assess the frequency with which various ophthalmic, optometric, anesthesia, and medical services are provided in conjunction with cataract surgery and to estimate the cost to Medicare associated with those services, we analyzed 1985 through 1988 Medicare claims records of a nationally representative 5% sample of Medicare beneficiaries. The experience of 57 103 Medicare beneficiaries who underwent extracapsular cataract surgery in 1986 or 1987 that was not combined with another ophthalmologic procedure formed the basis of our analysis. Projections for current costs were performed using 1991 charges allowed by Medicare for physician services. We estimate that the median charge allowed by Medicare for a "typical" episode of cataract surgery in 1991 was approximately $2500. In addition to the $3.4 billion that Medicare spent in 1991 on such "typical" episodes, Medicare spent more than $39 million on miscellaneous "atypical" preoperative ophthalmologic tests, such as specular microscopy (14% of cases) and potential acuity testing (8% of cases), more than $7 million on postoperative ophthalmologic diagnostic tests, such as fluorescein angiography (3% of cases), and more than $18 million on perioperative medical services (most commonly electrocardiography and chest roentgenography). The major determinants of the cost to Medicare associated with cataract surgery are the rate of performance of cataract surgery and neodymium-YAG laser capsulotomy and the charges allowed for these procedures. Many other ophthalmologic and medical services are often provided preoperatively and/or postoperatively, but total Medicare expenditures for these services are relatively small. References 1. Cataract Management Guideline Panel. Cataract in Adults: Management of Functional Impairment . Rockville, Md: US Dept of Health and Human Services; 1993. Public Health Service, Agency for Health Care Policy and Research publication 93-0542. 2. World Health Organization. Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death, Based on the Recommendations of the Ninth Revision Conference, 1975 . Geneva, Switzerland: World Health Organization; 1977. 3. Javitt JC, Tielsch JM, Canner JK, Kolb MM, Sommer A, Steinberg EP, on behalf of the Cataract Patient Outcomes Research Team. National outcomes of cataract extraction: increased risk of retinal complications associated with Nd: YAG laser capsulotomy . Ophthalmology . 1992;99:1487-1498.Crossref 4. Bloom BS, Krueger N. Cost and quality effects of outpatient cataract removal . Inquiry . 1988;25:383-387. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Loading next page...
 
/lp/american-medical-association/the-content-and-cost-of-cataract-surgery-ewTTUFKBE7
Publisher
American Medical Association
Copyright
Copyright © 1993 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1993.01090080037016
Publisher site
See Article on Publisher Site

Abstract

Abstract Although more than 1 million cataract surgeries are performed annually in the United States, little is known about the frequency of use or cost of various services provided in connection with this procedure. To assess the frequency with which various ophthalmic, optometric, anesthesia, and medical services are provided in conjunction with cataract surgery and to estimate the cost to Medicare associated with those services, we analyzed 1985 through 1988 Medicare claims records of a nationally representative 5% sample of Medicare beneficiaries. The experience of 57 103 Medicare beneficiaries who underwent extracapsular cataract surgery in 1986 or 1987 that was not combined with another ophthalmologic procedure formed the basis of our analysis. Projections for current costs were performed using 1991 charges allowed by Medicare for physician services. We estimate that the median charge allowed by Medicare for a "typical" episode of cataract surgery in 1991 was approximately $2500. In addition to the $3.4 billion that Medicare spent in 1991 on such "typical" episodes, Medicare spent more than $39 million on miscellaneous "atypical" preoperative ophthalmologic tests, such as specular microscopy (14% of cases) and potential acuity testing (8% of cases), more than $7 million on postoperative ophthalmologic diagnostic tests, such as fluorescein angiography (3% of cases), and more than $18 million on perioperative medical services (most commonly electrocardiography and chest roentgenography). The major determinants of the cost to Medicare associated with cataract surgery are the rate of performance of cataract surgery and neodymium-YAG laser capsulotomy and the charges allowed for these procedures. Many other ophthalmologic and medical services are often provided preoperatively and/or postoperatively, but total Medicare expenditures for these services are relatively small. References 1. Cataract Management Guideline Panel. Cataract in Adults: Management of Functional Impairment . Rockville, Md: US Dept of Health and Human Services; 1993. Public Health Service, Agency for Health Care Policy and Research publication 93-0542. 2. World Health Organization. Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death, Based on the Recommendations of the Ninth Revision Conference, 1975 . Geneva, Switzerland: World Health Organization; 1977. 3. Javitt JC, Tielsch JM, Canner JK, Kolb MM, Sommer A, Steinberg EP, on behalf of the Cataract Patient Outcomes Research Team. National outcomes of cataract extraction: increased risk of retinal complications associated with Nd: YAG laser capsulotomy . Ophthalmology . 1992;99:1487-1498.Crossref 4. Bloom BS, Krueger N. Cost and quality effects of outpatient cataract removal . Inquiry . 1988;25:383-387.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Aug 1, 1993

References