Outcomes and costs of outpatient and inpatient cataract surgery:: a randomised clinical trial

被引:41
|
作者
Castells, X [1 ]
Alonso, J
Castilla, M
Ribó, C
Cots, F
Antó, JM
机构
[1] Inst Municipal Assistencia Sanitaria, Studies Dept, Barcelona, Spain
[2] Inst Municipal Invest Med, Hlth Serv Res Unit, E-08003 Barcelona, Spain
[3] Hosp Esperanza, Dept Ophthalmol, Barcelona, Spain
[4] Inst Municipal Invest Med, Resp & Environm Hlth Res Unit, E-08003 Barcelona, Spain
[5] Univ Pompeu Fabra, Dept Expt & Hlth Sci, Barcelona, Spain
关键词
cataract extraction day case; randomised clinical trial; cost-effective; postoperative complications; health status;
D O I
10.1016/S0895-4356(00)00271-7
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
The aim of this study was to compare clinical and perceived health outcomes and cost between ambulatory and inpatient cataract surgery. An unmasked randomised clinical trial was undertaken. Cataract surgery patients of three public hospitals in Barcelona (Spain) who met inclusion criteria for ambulatory surgery were randomly assigned to two groups: outpatient hospital and inpatient hospital. Primary outcome measures were early and late postoperative surgical complications and visual acuity. Secondary outcome measures were perceived visual function, overall perceived health status, and costs. A total of 464 outpatients and 471 inpatients were analysed. No statistically significant differences were observed between the two groups in visual acuity (P =.48), nor for the other clinical and perceived health outcome measures, except for early postoperative complications. Outpatients presented at least one complication in the first 24 h after surgery more frequently than inpatients (64 vs. 43; RR 1.6, 95% CI 1.1, 2.4), but 4 months after surgery the differences in complications rates between groups disappeared. The cost of surgery was lower for outpatients than for inpatients (1001 vs. 1218 Euros; P <.001). Ambulatory cataract surgery was more cost-effective than inpatient surgery. Despite the higher risk of early complications in the outpatient hospital group, these differences may not be clinically relevant because the 4-month postoperative outcomes were not affected. (C) 2001 Elsevier Science Inc. All rights reserved.
引用
收藏
页码:23 / 29
页数:7
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