美国同日双侧白内障手术结局及经济因素的前瞻性分析。
Prospective analysis of outcomes and economic factors of same-day bilateral cataract surgery in the United States.
作者信息
Rush Sloan W, Gerald Ashley E, Smith Jason C, Rush J Avery, Rush Ryan B
机构信息
From the Panhandle Eye Group (S.W. Rush, Gerald, Smith, J.A. Rush, R.B. Rush), Texas Tech University Health Sciences Center (S.W. Rush, J.A. Rush, R.B. Rush), and Southwest Retina Specialists (R.B. Rush), Amarillo, Texas, USA.
From the Panhandle Eye Group (S.W. Rush, Gerald, Smith, J.A. Rush, R.B. Rush), Texas Tech University Health Sciences Center (S.W. Rush, J.A. Rush, R.B. Rush), and Southwest Retina Specialists (R.B. Rush), Amarillo, Texas, USA.
出版信息
J Cataract Refract Surg. 2015 Apr;41(4):732-9. doi: 10.1016/j.jcrs.2014.07.034. Epub 2015 Mar 6.
PURPOSE
To evaluate the visual and economic benefits of same-day bilateral cataract surgery versus separate-day bilateral cataract surgery in the United States.
SETTING
Private practice, Amarillo, Texas, USA.
DESIGN
Prospective controlled nonrandomized clinical trial.
METHODS
A cohort of patients having same-day bilateral cataract surgery was age-matched with a cohort of control patients who had standard separate-day bilateral cataract surgery. The primary outcome was a comparison of the direct cost for the patient, physician, ambulatory surgery center (ASC), and third-party payer.
RESULTS
The same-day cohort (42 patients, 84 eyes) had similar baseline characteristics and postoperative outcomes as the control cohort (42 patients, 84 eyes). The same-day cohort had less total distance traveled for care (P = .0039 and P < .0001 for in-town and out-of-town residents, respectively), less total time spent traveling for care (P = .0008 and P < .0001 for in-town and out-of-town residents, respectively), less total number of visits required for care (P < .0001), and less total time for vision recovery (P < .0001) than the control cohort. The physician and ASC reimbursements were lower in the same-day cohort (P = .0028 and P = .0016, respectively), whereas the total physician time spent caring for the patient in surgery was not different between the 2 groups (P = .7310). The total ASC expenses were higher in the same-day cohort (P < .0001). The total third-party payer cost was significantly less in the same-day cohort (P < .0001).
CONCLUSION
Visual and economic benefits for the patient can be achieved with same-day bilateral cataract surgery in the U.S. at the present time.
FINANCIAL DISCLOSURE
No author has a financial or proprietary interest in any material or method mentioned.
目的
评估在美国，同日双侧白内障手术与分日双侧白内障手术相比的视觉和经济效益。
地点
美国得克萨斯州阿马里洛的私人诊所。
设计
前瞻性对照非随机临床试验。
方法
一组接受同日双侧白内障手术的患者与一组接受标准分日双侧白内障手术的对照患者进行年龄匹配。主要结局是比较患者、医生、门诊手术中心（ASC）和第三方支付方的直接成本。
结果
同日手术组（42例患者，84只眼）与对照组（42例患者，84只眼）具有相似的基线特征和术后结局。同日手术组的就医总路程较短（市内居民P = 0.0039，市外居民P < 0.0001），就医总时间较短（市内居民P = 0.0008，市外居民P < 0.0001），所需就诊总次数较少（P < 0.0001），视力恢复总时间较短（P < 0.0001）。同日手术组的医生和ASC报销费用较低（分别为P = 0.0028和P = 0.0016），而两组医生在手术中照顾患者的总时间无差异（P = 0.7310）。同日手术组的ASC总费用较高（P < 0.0001）。同日手术组的第三方支付方总成本显著较低（P < 0.0001）。
结论
目前在美国，同日双侧白内障手术可为患者带来视觉和经济效益。
财务披露
没有作者对文中提及的任何材料或方法拥有财务或专利权益。
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