[Cost of cataract surgery in a public hospital]. / Évaluation du coût de la chirurgie de la cataracte dans un établissement public de santé

With more than 500,000 operations per year, cataract surgery is currently the most frequently performed surgical operation in France. Several procedural techniques are described, but phacoemulsification after micro-incision is the most common. The cost and reimbursement by the French social security depend on whether the procedure is conducted on an inpatient or outpatient basis. The objectives of this prospective study were to evaluate the cost of cataract surgery in a public hospital setting and to correlate differences in surgical practice with financial impact. One hundred twenty-five operations were observed in the operating room and many data points were recorded for analysis. Topical anesthesia was administered in 87.2% of cases; the mean duration of the surgery was 42minutes. The mean direct cost was 366 € (drugs, sterilization of reused equipment, medical devices, etc). The extended cost of the surgery (infrastructure, hospitalization, food and laundry, etc.) was computed to be 1130 € for outpatients and 1335 € for inpatients assuming a one-night stay in the hospital. In view of the reimbursement provided by social security, this innovative study in a public hospital demonstrates that cataract surgery is a profitable activity, reinforcing our strategic plans.

[Direct cost of cataract surgery in public hospital]. / Approche du coût direct de la chirurgie de la cataracte dans un établissement de santé public.

INTRODUCTION: With more than 500,000 operations per year, cataract surgery is the most performed act nowadays in France. Several techniques can be used but the phacoemulsification after micro-incision is the most common and the purpose is to put an intraocular lens into the eye. AIM: To approach the direct cost of the cataract surgery and to compare it to the amounts of reimbursements, and to get some epidemiological and statistical data about this surgery. MATERIAL AND METHODS: This study is prospective; many operations were followed up in the operating room and every following data were recorded: age of the patient, type of anaesthesia, type of intraocular lens, adverse events, name of surgeon, duration of the intervention, single use material and medications used during operation and their quantity for each operation. RESULTS: One hundred and twenty-five cataract surgeries were followed. Patients mean age was 74,1 years and the anaesthesia was topical in 87,2% of cases; only two patients had general anaesthesia. The mean duration was 42 minutes. The mean direct cost was 366 € but reached 630 € in case of capsular tear. The cost greatly varied depending on the surgeon. Two references of lens (foldable monofocal, that cost between 100 and 150 €) represented 80% of the implanted lenses. CONCLUSION: This type of study may lead to a standardisation of surgical techniques and evaluate the proportion of supply and medications in that type of surgery.