Increased use of ambulatory surgery centers for cataract surgery

November 22, 2017

National data shows a major shift in eye surgeries from hospitals to less expensive ambulatory surgery centers where care may be delivered faster and closer to home for some patients.

Over the past decade the proportion of surgeries performed at surgery centers increased steadily, reaching 73 percent in 2014, compared to 43.6 percent in 2001.

University of Michigan Kellogg Eye Center researchers revealed the increased use of surgery centers for cataract surgery, but say more research is needed to determine if there's a difference in safety between hospitals and surgery centers.

The large study using claims data for 369,320 enrollees age 40 and older in a nationwide managed care network who had cataract surgery was published Nov. 22 in JAMA Ophthalmology.

"The increase in utilization occurred in many U.S. communities such that in some places nearly every cataract surgery took place in an ambulatory care center," says senior author Joshua Stein, M.D., associate professor of ophthalmology and eye policy researcher at the U-M Institute of Healthcare Policy and Innovation.

Cataract surgery is extremely effective in restoring focusing power that can deteriorate with age. It carries little risk. But well-equipped hospitals are more prepared than a surgery center if medical complications happen.

Still the reasons for the increasing popularity of ambulatory surgery centers compared to hospital-based care include convenience, lower out-of-pocket costs for patients and decreased cost-per-case for insurers.

One analysis estimated that cataract surgeries performed at ambulatory surgery centers rather than hospitals saved Medicare $829 million in 2011.

Consumers save from the shift to surgery centers where average cataract co-pay in 2014 was $190 compared to $350 at a hospital outpatient department, authors write.

Patients were more likely to undergo cataract surgery at an  if they were younger age, had higher income, and lived in states without certificate-of-need laws. CON laws regulate the number of ambulatory care centers permitted to operate.

More affluent people were more likely to live in communities with more ambulatory care centers. This may have the indirect impact of limiting access to cataract surgery for less affluent .

"The increased use of ambulatory care centers raises questions about access and the effect on surgical outcomes, patient safety and patient satisfaction," says Brian Stagg, M.D., the study's lead author and a clinical scholar at the U-M Institute for Healthcare Policy and Innovation.

The shift is happening beyond cataract surgery and includes cornea, glaucoma, retina and strabismus surgery.

The rate of increase in ambulatory surgery center use for cataract surgery of 2.34% a year was similar to the rate of increase for strabismus surgery and retina surgery.

The rate of increase for glaucoma surgery was faster than cataract surgery. The rate of increase for cornea was slower than .

Explore further: Cataract surgery in older women associated with decreased risk of death

Related Stories

Cataract surgery in older women associated with decreased risk of death

October 26, 2017
In older women with cataracts in the Women's Health Initiative, cataract surgery was associated with a lower risk for overall and cause-specific death, although whether this association is explained by the intervention of ...

Patient age at initial cataract surgery varies by location

December 30, 2015
(HealthDay)—There is considerable geographic variation in patient age at initial cataract surgery across the United States, according to a study published online Dec. 30 in JAMA Ophthalmology.

Cataract surgery lessens patients' dizziness

November 24, 2015
Older people with visual impairment can report feeling dizzy and falling. A new study found that after routine cataract surgery, the improved vision led to patients experiencing significantly less dizziness, although they ...

Reduction in dizziness, not falls, after routine cataract surgery

November 12, 2015
(HealthDay)—Cataract surgery is associated with a reduction in the number of patients with dizziness, but not with a decrease in falls, according to a study published online Nov. 9 in Ophthalmic & Physiological Optics.

Review indicates benefits for bilateral cataract surgery

April 2, 2015
(HealthDay)—Immediately sequential bilateral cataract surgery seems beneficial, with faster rehabilitation, improved visual outcome, and savings in time and costs, according to a review published online March 30 in Clinical ...

Frailty associated with increased risk of complications following common, outpatient operations

October 11, 2017
Frailty was associated with an increased risk of complications among patients who underwent outpatient hernia, breast, thyroid or parathyroid surgery, with the findings suggesting that surgeons should consider frailty rather ...

Recommended for you

Newly published research provides new insight into how diabetes leads to retinopathy

December 7, 2017
An international team of scientists led by Professor Ingrid Fleming of Goethe University, Frankfurt, Germany, and including Professor Bruce Hammock of the University of California, Davis, provides new insight into the mechanism ...

Researchers use breakthrough technology to understand eclipse eye damage

December 7, 2017
In a first-of-its-kind study, Mount Sinai researchers are using adaptive optics (AO) to analyze retinal eye damage from the August solar eclipse on a cellular level. The research could help doctors develop a deeper understanding ...

Combating eye injuries with a reversible superglue seal

December 6, 2017
When a soldier sustains a traumatic eye injury on the battlefield, any delay in treatment may lead to permanent vision loss. With medical facilities potentially far away and no existing tools to prevent deterioration, medics ...

Trigger for most common form of vision loss discovered

November 27, 2017
In a major step forward in the battle against macular degeneration, the leading cause of vision loss among the elderly, researchers at the University of Virginia School of Medicine have discovered a critical trigger for the ...

Scientists engineer drug delivery device that treats glaucoma directly inside the eye

November 23, 2017
Glaucoma, which affects over 60 million people worldwide, can seem easy to treat: medicated eye drops can be used to ease the buildup of fluid in the eye that underlies the condition. If glaucoma is caught early, eye drops ...

Research reveals biological mechanism of a leading cause of childhood blindness

November 16, 2017
Scientists at the Virginia Tech Carilion Research Institute (VTCRI) have revealed the pathology of cells and structures stricken by optic nerve hypoplasia, a leading cause of childhood blindness in developed nations.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.