Increased Use of Ambulatory Surgery Centers for Cataract Surgery


Since past 10 years there has been a dramatic rise in the proportion of cataract surgeries performed at ambulatory surgery centers. Certain communities prefer their cataract surgeries in a surgery center rather than a hospital. The individuals preferred less expensive ambulatory surgery centers so that care may be delivered faster. While there was an increase in the expensive ambulatory surgeries, the researchers from the University of Michigan Kellogg Eye Center wanted to find its safety. Thus they reviewed the data of 369,320 enrollees (age ≥40 years) worldwide to find the difference in the safety between hospitals and surgery centers . The study is published in the JAMA Ophthalmology .

Joshua Stein, eye policy researcher at the UM Institute of Healthcare Policy and Innovation said that, "The increase in utilization occurred in many US communities such that in some places almost every cataract surgery took place in an ambulatory care center."

Cataract surgeries performed at ambulatory surgery centers saved Medicare $ 829 million in 2011, while the average cataract co-pay in 2014 was $ 190.Over the past 10 years, the proportion of cataract surgeries performed at surgery centers was increased steadily (up to 73%) . Although cataract surgery is effective in restoring focusing power, it carries little risk. The well-equipped hospitals were more prepared to cure these medical complications, but they were more economical.

The youths, higher income individuals and those who lived in states without a certificate-of-needy laws were more likely to undergo cataract surgery at an ambulatory surgery center. The number of ambulatory care centers permitted to operate was regulated by the CON laws.

As more affluent people were more likely to live in communities with more ambulatory care centers, the less affluent patients may get less access to cataract surgery .

Brian Stagg from the UM Institute for Healthcare Policy and Innovation reported, "The increased use of ambulatory care centers raises questions about access and the effect on patient outcomes, patient safety and patient satisfaction."

The researchers observed a shift that happens beyond cataract surgery and includes cornea, retina, glaucoma, and strabismus surgery. When the rate of increase in ambulatory surgery was used for cataract surgery (2.34% a year), it was similar for strabismus and retina surgery, the rate was increased for glaucoma surgery and lowered for cornea surgery.