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同期序贯双侧白内障手术与延期序贯双侧白内障手术:潜在的医院成本节约。

Immediately sequential bilateral cataract surgery versus delayed sequential bilateral cataract surgery: potential hospital cost savings.

机构信息

London Health Science Centre, University of Western Ontario, London, Ont.

出版信息

Can J Ophthalmol. 2010 Dec;45(6):596-601. doi: 10.3129/i10-094.

Abstract

OBJECTIVE

Cataract surgery represents a substantial cost to health care systems around the world. Canada's socialized medical system allows an opportunity to accurately track costing because of the institutional record keeping necessary for public reporting to provincial governments. Cataract surgical costs consist of medical costs, hospital costs, and social costs. Our study compared the hospital costs of immediately sequential bilateral cataract surgery (ISBCS) with delayed sequential bilateral cataract surgeries (DSBCS), minimizing other interfering variables.

DESIGN

Retrospective chart review with collection of associated costing information from the hospital.

PARTICIPANTS

Twenty-two consecutive patients undergoing ISBCS with posterior chamber intraocular lens implantation and a randomly selected group of 22 patients undergoing similar DSBCS during the same period.

METHODS

Hospital costs were determined using the London Health Sciences Centre case-costing system. Average costs were calculated and compared statistically.

RESULTS

Average hospital costs were significantly reduced when performing ISBCS (p < 0.0001); 2 separate unilateral cataract surgeries totaled $1566.30, compared with $1059.10 for one bilateral cataract surgery (32.4% reduction). Pre- and post-operative in-hospital care accounted for a significant portion of this difference (54%), as 2 separate surgeries cost $547.92 compared with $273.96 for ISBCS.

CONCLUSIONS

ISBCS provided considerable hospital cost savings compared to DSBCS.

摘要

目的

白内障手术是全球医疗保健系统的一项重大支出。加拿大的社会化医疗体系允许通过向省政府进行公共报告所必需的机构记录保存,准确跟踪成本。白内障手术的成本包括医疗成本、医院成本和社会成本。我们的研究比较了即刻序贯双侧白内障手术(ISBCS)和延迟序贯双侧白内障手术(DSBCS)的医院成本,同时最小化了其他干扰变量。

设计

回顾性图表审查,并从医院收集相关成本信息。

参与者

22 例连续接受 ISBCS 并植入后房型人工晶状体的患者,以及同期随机选择的 22 例接受类似 DSBCS 的患者。

方法

使用伦敦健康科学中心病例成本核算系统确定医院成本。计算平均成本并进行统计学比较。

结果

当进行 ISBCS 时,平均医院成本显著降低(p<0.0001);2 次单侧白内障手术总计 1566.30 加元,而 1 次双侧白内障手术为 1059.10 加元(降低 32.4%)。术前和术后住院护理占这一差异的很大一部分(54%),因为 2 次单侧手术的费用为 547.92 加元,而 ISBCS 的费用为 273.96 加元。

结论

与 DSBCS 相比,ISBCS 可显著节省医院成本。

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