Moorfields Eye Hospital NHS Foundation Trust, 162 City Road, London EC1V 2PD, UK.
Br J Ophthalmol. 2012 Jan;96(1):114-7. doi: 10.1136/bjo.2010.200832. Epub 2011 Mar 1.
To estimate the direct financial burden to healthcare purchasers of a posterior capsule tear (PCT) during cataract surgery.
A retrospective data analysis of cataract surgeries was performed. Patients who had surgery in the 2-year period from April 2005, with a maximum follow-up, to April 2009 were identified. Patients previously under review for ocular comorbidity apart from cataract were excluded. Each case with PCT was matched with an uncomplicated cataract operation performed on the same list by the same grade of surgeon. For both groups, we extracted details of all additional subsequent visits and interventions. Data on the cost of visits and procedures were provided by the Department of Health. We then compared this data between groups.
A total of 100 patients with PCT were matched with 100 controls. The preoperative parameters of the two groups were similar. The cases required a median of 3 (mean 3.6, range 0-24) additional postoperative visits compared with 0 (mean 0.19, range 0-8) for controls, with a median duration of follow-up of 74 (mean 129.5, range 6-1316) days for cases compared to 21 (mean 26.1, range 0-308) days for controls (p=0.000). The average cost of extra visits was £ 475.0 (SD £ 697.8) for cases and £ 69.2 (SD £ 51.0) for controls (p<0.001).
Based on the National Health Service national tariff, a PCT during cataract surgery results in significant additional financial cost to healthcare purchasers. A full cost analysis would be required to estimate the additional cost of a PCT for the healthcare provider.
评估白内障手术中后囊破裂(PCT)对医疗保健购买者的直接财务负担。
对白内障手术进行回顾性数据分析。确定了 2005 年 4 月至 2009 年 4 月期间进行手术的患者,并进行了为期 2 年的随访。排除了除白内障以外还有眼部合并症而正在接受审查的患者。将每组中每例 PCT 病例与同一列表中由同一级别外科医生进行的单纯白内障手术相匹配。对于两组患者,我们都提取了所有后续就诊和干预的详细信息。就诊和手术的费用数据由卫生部提供。然后我们对两组数据进行了比较。
共有 100 例 PCT 患者与 100 例对照患者相匹配。两组患者的术前参数相似。病例组需要中位数 3 次(均值 3.6,范围 0-24)额外的术后就诊,而对照组仅需 0 次(均值 0.19,范围 0-8),病例组的中位随访时间为 74 天(均值 129.5,范围 6-1316),而对照组为 21 天(均值 26.1,范围 0-308)(p=0.000)。额外就诊的平均费用为病例组 475.0 英镑(SD 697.8 英镑),对照组为 69.2 英镑(SD 51.0 英镑)(p<0.001)。
根据国民保健制度国家收费标准,白内障手术中发生后囊破裂会给医疗保健购买者带来显著的额外财务负担。需要进行全面成本分析才能估算出医疗服务提供者因 PCT 而增加的成本。