Department of Community and Family Medicine, Dartmouth Health and Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
Department of Anesthesiology and Perioperative Medicine, Dartmouth Health, Lebanon, NH, USA.
BMC Health Serv Res. 2024 Sep 17;24(1):1087. doi: 10.1186/s12913-024-11484-0.
Cataract surgery is one of the most common surgical procedures performed in older adults in the United States and is generally considered to be extremely low-risk. As of 2019, routine preoperative evaluation within 30 days of surgery is no longer mandated by the United States of America (USA) Centers for Medicare & Medicaid Services (CMS) for ambulatory surgery centers, but it is unclear how primary care providers perceive this change.
We performed a qualitative analysis of semi-structured interviews with six primary care providers to explore primary care providers' perspectives on routine preoperative assessment for cataract surgery.
Primary care providers commented on the large number of referrals they receive for preoperative assessment before cataract procedures. The analysis revealed an overarching sentiment of resentment over the time, effort, and resources expended on these assessments. Themes included the lack of awareness of the updated regulations that no longer require a history and physical to be completed within 30 days and the perception of a universal lack of medical necessity to perform preoperative assessment for cataract surgery. Providers also commented on the strain on limited resources and the burden on patients. The relationship between specialties and professional roles emerged as another important theme.
Referrals for preoperative clearance for cataract surgery continue to burden providers, patients, and the health system, and represent an opportunity to streamline care in this patient population.
在美国，白内障手术是老年人群中最常见的手术之一，通常被认为是风险极低的手术。自 2019 年以来，美国医疗保险和医疗补助服务中心（CMS）不再要求门诊手术中心在手术前 30 天内进行常规术前评估，但尚不清楚初级保健提供者如何看待这一变化。
我们对六位初级保健提供者进行了半结构化访谈的定性分析，以探讨初级保健提供者对白内障手术常规术前评估的看法。
初级保健提供者对他们在白内障手术前收到的大量转介进行了评论。分析显示，他们对在这些评估上花费的时间、精力和资源感到不满。主题包括对不再要求在 30 天内完成病史和体检的更新规定缺乏认识，以及对白内障手术进行术前评估缺乏普遍的医疗必要性的看法。提供者还评论了有限资源的紧张状况和患者的负担。专业之间的关系和专业角色的出现是另一个重要的主题。
白内障手术术前清除的转介继续给提供者、患者和医疗系统带来负担，这代表了在这一患者群体中简化护理的机会。
