Simultaneous bilateral cataract surgery: Economic analysis; Helsinki Simultaneous Bilateral Cataract Surgery Study Report 2

PURPOSE: To present an economic-analysis comparison of simultaneous and sequential bilateral cataract surgery. SETTING: Helsinki University Eye Hospital, Helsinki, Finland. DESIGN: Economic analysis. METHODS: Effects were estimated from data in a study in which patients were randomized to have bilateral cataract surgery on the same day (study group) or sequentially (control group). The main clinical outcomes were corrected distance visual acuity, refraction, complications, Visual Function Index-7 (VF-7) scores, and patient-rated satisfaction with vision. Health-care costs of surgeries and preoperative and postoperative visits were estimated, including the cost of staff, equipment, material, floor space, overhead, and complications. The data were obtained from staff measurements, questionnaires, internal hospital records, and accountancy. Non-health-care costs of travel, home care, and time were estimated based on questionnaires from a random subset of patients. The main economic outcome measures were cost per VF-7 score unit change and cost per patient in simultaneous versus sequential surgery. RESULTS: The study comprised 520 patients (241 patients included non-health-care and time cost analyses). Surgical outcomes and patient satisfaction were similar in both groups. Simultaneous cataract surgery saved 449 Euros ((sic)) per patient in health-care costs and (sic)739 when travel and paid home-care costs were included. The savings added up to (sic)849 per patient when the cost of lost working time was included. CONCLUSION: Compared with sequential bilateral cataract surgery, simultaneous bilateral cataract surgery provided comparable clinical outcomes with substantial savings in health-care and non-health-care related costs.