Immediately sequential bilateral cataract surgery versus delayed sequential bilateral cataract surgery: potential hospital cost savings

OBJECTIVE: Cataract surgery represents a substantial cost to health care systems around the world. Canada's socialized medical system allows an opportunity to accurately track costing because of the institutional record keeping necessary for public reporting to provincial governments. Cataract surgical costs consist of medical costs, hospital costs, and social costs. Our study compared the hospital costs of immediately sequential bilateral cataract surgery (ISBCS) with delayed sequential bilateral cataract surgeries (DSBCS), minimizing other interfering variables. DESIGN: Retrospective chart review with collection of associated costing information from the hospital. PARTICIPANTS: Twenty-two consecutive patients undergoing ISBCS with posterior chamber intraocular lens implantation and a randomly selected group of 22 patients undergoing similar DSBCS during the same period. METHODS: Hospital costs were determined using the London Health Sciences Centre case-costing system. Average costs were calculated and compared statistically. RESULTS: Average hospital costs were significantly reduced when performing ISBCS (p < 0.0001); 2 separate unilateral cataract surgeries totaled $1566.30, compared with $1059.10 for one bilateral cataract surgery (32.4% reduction). Pre- and post-operative in-hospital care accounted for a significant portion of this difference (54%), as 2 separate surgeries cost $547.92 compared with $273.96 for ISBCS. CONCLUSIONS: ISBCS provided considerable hospital cost savings compared to DSBCS.